Early on in my professional journey as a behavioral health clinician I led a psychotherapy group at a residential treatment center where all of the members of this adult co-ed group were dual diagnosis, substance use – self-mutilating behaviors, group. Part of the group dynamic was the exploration of the clients outside of their diagnostic labels.
I used the Physical/Mental/Spiritual framework for that exploration. I always found that an interesting exercise to begin to explore what it meant to individuals to see themselves outside of the “illness” they had been trapped inside and how to consider, even if non-religious, what it means to be an active member of the universe. They could be more than their “addiction” and self-injurious behavior. They already were more but being given permission to explore and embrace that carried a lot of healing power.
As a former United Methodist Pastor, it was always interesting leading a conversation about spirituality as opposed to religiosity. For some people, there is no difference between these two ideas, but I think there can always be a helpful conversation of the spiritual nature of the individual regardless of the client’s and your religious framework. And, to me, this conversation starts in the assessment process.
When thinking about social assessment as part of biopsychosocial assessment, it can be incredibly helpful to understand the role that religion plays with the client. Do they have a faith-based framework in their lives? Do they have social supports in the world? Or is it part of their trauma? Did they learn shame and regret from their interactions with a religious world? Religion can be an important support or a key point of trauma – or it can mean very little.
Whether religion was a positive or negative frame for the client, it is an important conversation to have as it will enter into the work at some point. But what if your client tells you that they have “no spiritual” part of their life? Do we write it down and move on? Or do we explore what that means?
While I’m not necessarily advocating derailing the entire biopsychosocial assessment to delve down the “spirit” path, I think it can be instructive to the therapist to understand how your client sees themselves in context of the world around them. The spiritual variables conversation can provide an avenue for healing even without any sort of religious framework.
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