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Chapter 5: Conclusions and Discussion
Professional Attitudes and Professional Practice
The professional attitudes of Bachelors of Social Work (BSW) students surveyed are very much in favor of the inclusion of spirituality in social work. The RRSP scale measures
professional attitudes towards spirituality and religion and a higher score predicts greater support for the inclusion of spirituality and religion into the profession of social work. The mean RRSP score in this study was 70.4 (ranging 45-90) which is similar but slightly higher than Graff‟s (2007) survey of BSW students. The scores in Graff‟s study ranged from 30 to 86 with a mean of 66.38. Another recent study with practitioners yielded a mean score of 68.7 (Kvarfordt & Sheridan, 2007) consistent with other studies. Student in this study were more neutral towards the use of spiritual and religious interventions than Graff (2007). For example, when asked if it is appropriate to use religious texts with a client, 31.9% of the students in this study disagree while 50% of Graff‟s respondents disagreed. A considerable percent of students in this study were neutral in their response (41.6% - neither agreed nor disagreed). Existing research identifies professional attitudes as the most important predictor of intervention use in practice (Heyman, Buchanan, Musgrave et al., 2006, Kvarfordt & Sheridan, 2008, Murdock, 2005, Sheridan, 2004). Even though the undergraduate students in this sample are not currently practicing, their professional attitudes are more likely to shape their future work with clients. Therefore, the highly positive view of spirituality and religion found in this sample indicate that these students are likely to incorporate spirituality and religion into their professional practice. The lack of significant relationships between the RRSP score and demographic variables indicates that regardless of gender, age, race, and type of institution, students overwhelmingly support the inclusion of spirituality and religion in social work.
35 Personal Spirituality and Professional Attitudes
This sample of undergraduate social work students reported a very high level of
spirituality. This finding is consistent with Graff (2007) wherein 94% of BSW students believed in a God who is active in the world. Interestingly, Stewart, Koeske, and Koeske (2006) found that African American respondents were significantly more spiritual than Caucasian respondents, which is consistent with the finding in this study. Minority students were more likely to be highly spiritual than non-minority students.
The study found that professional attitudes about spirituality and religion are strongly correlated with personal spirituality and religious service attendance. This finding is consistent with a growing body of literature connecting personal spirituality with professional attitudes and use of spiritual interventions in practice. In their pathway factor analysis, Kvarfordt and
Sheridan (2009) found that personal spirituality appears to be an important first link, in a chain of factors which cause practice behaviors. The significant correlation found in this study between spirituality and attitudes is consistent with the first step in Kvarfordt & Sheridan‟s model which suggests that „Personal Religious/Spiritual Practices influences professional attitudes and Practice-Related Experiences which in turn can impact the intervention one uses. Another model found that spirituality directly affects the utilization of religious interventions, rather that affecting it indirectly through shaping attitudes and perceptions (Stewart, Koeske, & Koeske 2006). Research has consistently shown personal spiritual and religious variables to be predictors of higher intervention use (Heyman, Buchanan, Musgrave et al., 2006, Kvarfordt & Sheridan, 2008, Murdock, 2005, Senstoack & Van Asselt, 2009, Sheridan, 2004). As these BSW students will soon be practicing social workers, it is likely that their high level of spirituality will result in more frequent use of spiritual interventions with clients.
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However, the high number of neutral responses to questions about the appropriateness of specific interventions likely indicates that students are unclear about how to implement the use of spirituality and religion in their work with clients. Students are clearly in favor of the inclusion of spirituality but they are less clear in their understanding of how it should be done. This uncertainty points back to social work education to be training students to ethically and competently manage these issues in practice.
State of Spirituality in Social Work Education
Students agree that content on spirituality and religion should be included in social work education. Overall, 84.3% agreed that social work education should include content on religious and spiritual diversity and 89.2% agreed to include content on how to effectively deal with religious and spiritual issues in practice. This finding was mirrored in the Graff study (2007) with 82.1% and 87.6% respectively. However, results of this study show an obvious discrepancy between what they students believe is a vital part of their education, and the content they are actually receiving. The finding that 67% of students have never received course content on spirituality or religion is consistent with over 15 other studies of social work practitioners, educators, and students, all which reported between 66% and 89% of respondents received little to no instruction on spirituality or religion during their social work education (Sheridan, 2009). The oldest of these studies was conducted in 1992, indicating that social work education has changed very little over the last 20 years.
Another notable finding related to education is the negative association between students receiving course content on spirituality and religion and their level of perceived preparedness to handle these issues in practice. This lack of educational effect is also found in the literature
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where educational variables were found to have little to no effect on intervention use (Kvarfordt & Sheridan, 2008). It is probable that the limited impact of education is relative to the minimal exposure to content on religious and spiritual issues in their professional education.
Results of the Spiritual Competence Scale indicate that public undergraduate social work programs are more likely to discriminate, censor, and be less open to expressing religious and spiritual beliefs than private universities. Although this is a relatively new scale and no data could be found for comparison, it is clear that students at public universities feel their educational programs need to improve their spiritual competence.
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Chapter 6: Implications and Limitations
6.1 Implications
Implications for Policy
Even though there is a body of literature spanning over 20 years calling for the inclusion of spirituality and religion into social work education, very little has changed in the educational system. It is time for the profession to take action to ensure future social workers are prepared for the challenges they will face with these issues in practice. The population is constantly changing due to globalization and the populations that social workers serve are also rapidly diversifying. It is now more likely than ever that social workers will encounter diverse religious and spiritual beliefs in practice.
Schools of social work need to thoroughly investigate their current level of inclusion of spiritual course content and the methods used to train students in its application. To ensure that students and faculty feel safe to explore and discuss issues of spirituality, schools should review existing policies, both explicit and implicit, regarding the treatment of religion and spirituality in their programs. The current data suggests that private colleges are more open to integration of spirituality and religion in their courses than public universities. However, regardless of the type of university, social work educational institutions should take the initiative to understand how these issues are taught in the classroom. Faculty should be trained on how to facilitate open conversation about religion and spirituality and promote introspection of one‟s own spirituality while being sensitive to other cultural beliefs. If nowhere else, schools of social work should be the place where these often avoided yet crucial conversations about spirituality are embraced in the interest of competent and ethical practice.
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Furthermore, change in social work education is usually driven by governing bodies and ethical standards. The Council on Social Work Education and the National Association of Social Workers both explicitly call for the inclusion of spirituality and religion in social work for the purpose for cultural competence. Therefore, embracing spirituality and religion into social work education would uphold the professional standards. However, these governing bodies should use their authority to actively promote and enforce the inclusion of spirituality and religion into undergraduate education. The lack of specific guidelines may be contributing to the slow response to the call for inclusion of spirituality and religion. The CSWE and the NASW should outline specific expectations and recommendations for social work education to follow which will guide the process of implementing curriculum changes.
Implications for Practice
While it is necessary that social work students gain knowledge about spirituality and religion, it is even more crucial that they be able to apply this education in practice. Practical training begins in social work practice courses, where students are taught strategies for implementing knowledge and theory into their work with clients. Spirituality and religion should be integrated into these practice classes so that students gain exposure to methods of spiritual assessment and interventions to use with clients. There are many innovative tools being developed for engaging client spirituality and religion that could be presented in these courses (Hodge, 2005, Waller & Sori, 2006). Also, methods of instruction using role-plays, modeling, cultural exposure assignments would all be useful in helping students gain skill to engage issues of spirituality and religion in practice. Additionally, a great deal of practice instruction occurs in a student‟s field placement. Colleges should offer training for field instructors on spirituality and religion in order that they may integrate these topics with students in field placements. Research
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has found that the majority of social workers trained in the past 20 years have not received training on spirituality and religion in their professional education. Therefore, universities and the NASW should offer workshops and continuing education to better equip current practitioners to engage spirituality and religion in their current practice.
Suggestions for Future Research
Studies show for the past 15 years, the rate of integration of spirituality and religion in education as reported by the respondents remains stagnant (Sheridan, 2009). There has been a movement in the field to integrate course content but has not been successful. It is speculated that a reason for lack of integration may be due to deficits in active engagements of student and faculty feedback on the content of the curriculum. Therefore, a well thought through process for gaining input to help substantiate the core curriculum content on spirituality would be beneficial. It is suggested that a study be conducted using focus groups to gather student and faculty input into the development of spiritual and religious course content. This would further the
understanding of their current experiences as well as collect ideas for implementing changes. Course content should then be developed and piloted in a few schools, both public and private. The curriculum should be tested for effectiveness using a pre-post evaluation model. Strategies used in adult learning pedagogical models should be considered when designing the new course content.
Studies show that the two most important predictors of use of spiritual interventions in practice are personal spirituality and professional attitudes. This study confirms a strong correlation between personal spirituality and professional attitudes (r = , p < .01). To further understand the development of personal spirituality, professional attitudes, and the
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interrelationship between the two, future research should to collect longitudinal data from social work students as they move through their undergraduate and graduate education. This would help explain the factors that influence the development of these attitudes and if education has an effect over time.
Although there was some religious diversity represented in this sample, the vast majority are Christian or were raised Christian. This is also true of most other studies reviewed in the literature. It would be interesting to recruit individuals from diverse religious backgrounds and explore their experiences and attitudes more thoroughly.
As noted in the limitations section, future studies need to increase sample sizes to make the findings generalizable to the larger population of undergraduate social work students.
6.2 Limitations
Interpretation of study findings must always account for methodological limitations. First, as previously mentioned, it is impossible to assess the adequacy of the response rate, as not list exists of how many students in the target population have completed the required three social work courses. Future studies should consider using other criteria for qualification such as class rank (junior, senior etc.) that would allow for easier comparison. Secondly, the efficacy of this study relied on the compliance of program administrators with the research protocol. There is no way of knowing to what degree they followed the researcher‟s instructions when disseminating the survey. Student responses could have been affected if they deviated from the protocol i.e. adding to the solicitation email, delaying to send the surveys etc. Additionally, the small sample size could have prevented some of the statistical tests and chi squares from showing significance. A larger sample would include more variance in responses and may reveal further correlations
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among the variables. To increase student participation, the time allotted for completing the survey should be increased. Two weeks seems to be an inadequate amount of time for
solicitation of survey completion, as students tend to postpone engagement in activities that are not of high priority. In order to increase the response rate, one should be aware of the timing for initial recruitment of programs. Programs should be contacted early during the quarter or
semester as it is difficult to access administrators at the end of a semester and over breaks. The inability to contact program administrators decreased the opportunity to recruit more schools to participate.
43 References
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Burcham, S. & DeCoster, V. (2002). Graduate social work students' attitudes about client religion. Social Thought, 21(2), 75. Retrieved from SocINDEX with Full Text database.
Bushfield, S., & Hodge, D. (2006). Developing Spiritual Competence in Practice. Journal of Ethnic & Cultural Diversity in Social Work, 15(3/4), 101-127.
doi:10.1300/J051v15n03 05.
Council on Social Work Education. (2008). Educational policy and accreditation standards. Alexandria, VA: Author.
Graff, D. (2007). A study of baccalaureate social work students' beliefs about the inclusion of religious and spiritual content in social work. Journal of Social Work Education, 43(2), 243-256. Retrieved from Social Work Abstracts database.
Heyman, J. C., Buchanan, R., Musgrave, B., & Menz, V. (2006). Social workers‟ attention to clients‟ spirituality: Use of spiritual intervention in practice. Arete, 30(1), 78–89.
Hodge, D. (2005). Spirituality in Social Work Education: A Development and Discussion of Goals that Flow from the Profession's Ethical Mandates. Social Work Education, 24(1), 37-55. doi:10.1080/0261547052000324982.
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Hodge, D. (2005). Developing a Spiritual Assessment Toolbox: A Discussion of the Strengths and Limitations of Five Different Assessment Methods. Health & Social Work, 30(4), 314-323. Retrieved from EBSCOhost.
Hodge, D. (2007). The Spiritual Competence Scale: A New Instrument for Assessing Spiritual Competence at the Programmatic Level. Research on Social Work Practice, 17(2), 287- 295. doi:10.1177/1049731506296168
Koeske, G., & Koeske, R. Stewart, C. (2006). Personal religiosity and spirituality associated with social work practitioners' use of religious based intervention practices. Journal of
Religion & Spirituality in Social Work, 25(1), 69-85. Retrieved from Social Work Abstracts database.
Kvarfordt, C., & Sheridan, M. (2007). The Role of Religion and Spirituality in Working with Children and Adolescents: Results of a National Survey. Journal of Religion & Spirituality in Social Work, 26(3), 1-23. doi:10.1300/J377v26n03-01
Kvarfordt, C., & Sheridan, M. (2009). Understanding the pathways of factors influencing the use of spiritually based interventions. Journal of Social Work Education, 45(3), 385-405. Retrieved from SocINDEX with Full Text database.
Murdock, V. (2005). Guided by ethics: Religion and spirituality in gerontological social work practice. Journal of Gerontological Social Work, 45(1/2), 131–154.
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Senstock, T. & Van, A., (2009). Influence of counselor spirituality and training on treatment focus and self-perceived competence. Journal of Counseling & Development, 87(4), 412- 419. Retrieved from Social Work Abstracts database.
Sheridan, M. (2009). Ethical issues in the use of spiritually based interventions in social work practice: what are we doing and why. Journal of Religion & Spirituality in Social Work, 28(1-2), 99-126. Retrieved from Social Work Abstracts database.
Sheridan, M. (2004). Predicting the use of spiritually-derived interventions in social work practice: a survey of practitioners. Journal of Religion & Spirituality in Social Work, 23(4), 5-25. Retrieved from Social Work Abstracts database.
Smolak, A., & Williams, M. (2007). Integrating Faith Matters in Social Work Education. Journal of Religion & Spirituality in Social Work, 26(3), 25-44. doi:10.1300/J377v26n03-02.
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guidelines, and population distribution for the daily spiritual experience scale. Archive for the Psychology of Religion, 28(1). 181-218. doi: 10.1163/008467206777832562
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counseling II: Homework, handouts and activities for use in psychotherapy. New York: Haworth Press.
46
Appendix A: Formal Solicitation Letter to Program Administrators
Dear Social Work Director,
I am writing to invite your Social Work program to participate in an exciting and ground breaking research project. Spirituality is a topic often confused, mistreated, and avoided in the Social Work profession. However, most clients hold some spiritual belief and consider that belief to be a strength. As Social Workers seeking to provide holistic services, it is imperative we become better equipped to engage clients on their spiritual and religious beliefs. The NASW Code of Ethics compels us to become culturally competent with the populations we serve, including respect of religious diversity. As you know, Bachelors programs are the training ground for the next generation of Social Workers. Their beliefs and values will shape the future of the profession and the future role of spirituality and religion in Social Work practice.
I am proud to introduce to you the research team of BSW student Stephanie Neal and Dr. Shantha Balaswamy from the Ohio State University, College of Social Work. This year, they will be exploring Bachelors of Social Work students‟ personal and professional perspectives on the role of religion and spirituality in Social Work. Your Bachelors of Social Work students are invited to participate in this study and make their opinions some of the first to be heard on this subject. And you will be among the first to receive the results of this study!
But we need your help to make this project a success! We are asking if you would partner with us in helping disseminate the online survey to students in your program by forwarding an email containing the link to the survey to your students. The email will be sent in January 2011. The student, Stephanie Neal, will be contacting you shortly to follow-up about your Social Work program‟s participation in this research. I sincerely hope you will partner with NASW in making this exciting research a success.
Sincerely,
Cindy Webb
47 Appendix B: Student Solicitation Email
Dear Student,
We are contacting you with an opportunity to share your personal and professional perspectives on the role of spirituality and religion in Social Work. The survey asks about your professional and personal beliefs about spirituality and your experience in