Ethical_Issues_for_the_Integration_of_Religion_and_Spirituality_in_Therapy

Ethical Issues for the Integration of Religion and Spirituality in Therapy Ethics and Standards of Professional Psychology Patricia Elias Kaplan University   Abstract Over the past ten years, new developments in the psychological treatment and assessment of clients of diverse spirituality and religiosity has occurred. These changes have prompted the need for a broader understanding of therapeutic practices related to client spirituality and religiosity. Individual differences, rareness of research regarding the harm or benefits of introducing the idea of faith into treatment, diversity among groups regarding religious practices and values have created new ethical dilemma (Fisher, 2009). Religion and spirituality are important components in the lives of most psychotherapy clients. However, most psychotherapists lack sufficient training to effectively and ethically address these issues with their clients (Barnett, 2011). This paper discusses the various Standards and Principles defined by the Code of Ethics that pertain to the clinical treatment of religious clients. Ethical considerations include assessments, advertising and public statements, informed consent, competence, boundary issues, multiple relationships, cooperation with other professionals, and methods of successful integration of religious and spiritual interventions in ongoing psychotherapy. Ethical Considerations in a Religious Therapy Setting Since these recent developments have created ethical dilemmas, before a therapist begins treatment they should familiarize themselves with how religion presents itself in mental health and psychopathology and ensure that no ethical standards have been breached: (Standards 2.01b Boundaries of Competence and 2.03, Maintaining Competence). These standards relate to the expertise and training of the psychologist, procedures which assess and treat clinically pertinent religious/spiritual beliefs and emotional reactions, and the comprehension of information regarding mental health efficacy of religious imagery, prayer or other religious techniques (Fisher, 2009). When treating a religious client, the professional should be aware of Principle B; the psychologist strives to be aware of their own belief systems, values, needs and limitations and the effect of these on their work (APA 1992). In the event that the psychologist is unable to provide effective treatment based on their personal beliefs or insufficient knowledge of the clients belief system, they should immediately refer to another clinician whose expertise is more suited to the client's needs. Inclusion in to a religious group or tradition does not constitute expertise or should be inferred otherwise (Standard 5.01: Avoidance of False or Deceptive Statements) Many religious clients are uncomfortable with working with professionals who do not share or understand their beliefs (Carpenter, 2003). Carpenter claims this occurs because the overt trait of religiosity is overlooked. In addition he stated that the provision of an effective and therapeutic relationship depends on the therapists ability to refrain from imposing their own beliefs or values on to the client. As such, the clinician should ascertain whether they harbor any religious bias that may damage the efficacy of treatment.( Principle D: Justice and Principle; Principle E: Respect for People's Rights and Dignity; Standards 2.06. Personal Problems and Conflicts, and 3.01. Unfair Discrimination). Information regarding the origin of the clients beliefs is beneficial to treatment. Standard 3.09, cooperation with other professionals, allows the psychiatrist to partner with clergy to gain further understanding of the clients religion, and the avoidance of encroaching on theological domains (Fisher, 2009) . Consequently, the cooperation increases the likelihood that a clients incorrect religious interpretations will be addressed in the right manner within their faith (Standards 2.01b Boundaries of Competence and 2.03, Maintaining Competence). Written permission must be obtained from the client before a conversation transpires between psychologist and clergy and only information that is relevant and provides advantageous assistance to the client can be shared (Standard.3.10 Informed Consent; Standard 4.01 Maintaining Confidentiality). Care should be taken to ensure that there is no overlapping of roles when establishing the best methods of assisting the client (Standard 3.05; Multiple Relationships and Standard 3.08; Exploitative Relationships Standard 4.05 Disclosures). Conclusion The professional encounters many therapeutic challenges when treating religious clients. Spiritualizing problems, relational conflicts related to gender role expectations, addictions, and the religious agenda of family and clergy are some that the client may be experiencing (Aten, Mangis & campbell, 2010). Shafraiske, (2009) states religious or spiritual beliefs often provide alternative meanings regarding success and failure, satisfaction and disappointment, in addition to providing models of justice, forgiveness and acceptance, sin, guilt and retribution. These beliefs provide the opportunity for professionals to assess ways in which the client views themselves in relation to the outside world. Furthermore, professionals should be cognizant of the experiences of prayer, spiritual understanding of acceptance which includes judgment, condemnation and fear which are often deep and transforming experiences for the client. Effective treatment depends upon the professionals evaluation of personal attitudes, sensitivity to clients rigid beliefs, acknowledgement and addressing of religious differences and an understanding of clients culture and world view (Aten, Mangis & campbell, 2010).   References: Aten, J. D; MangisM. W. & Campbell, C. (2010) Psychotherapy with Rural Religious Fundamentalist Clients. Journal of Clinical Psychology. May2010, vol, 66,5,513-523 Barnett, J. (2011) Integrating Spirituality and Religion Into Psychotherapy: Persistent Dilemmas, Ethical Issues and a Proposed Decision Making Process. Ethics and Behavior: Mar/Apr2011: Vol, 21,2,147-164 Carpenter, D. MA. PhD. (2003) Ethical Considerations When Working with Religious Clients. Retrieved from http://www.g-gej.org/1-2/religious_clients.html Fisher, C. B. (2009) Decoding the Ethics Code: A Practical Guide for Psychologists. 2nd. ed. Thousand Oaks, CA. Sage Publications. Genia, V. (1994) Secular Psychotherapists and Religious Clients: Professional Considerations and Recommendations. Journal of Counseling and Development, Mar/Apr 94; vol, 72,4,395-398. Shafraiske, E. P. (2009) Spiritually Oriented Psychodynamic Psychotherapy. Journal of Clinical Psychology. Feb 2009, vol 65,2,147-157