A Series of Progressive Legal and Ethical Decision-Making Steps for Using Christian Spiritual Interventions in Psychotherapy

Abstract

Recently, there has been a growing trend in the professional literature to address the question: “In what ways should spiritual interventions be used in counseling, with which clients, and under which circumstances?” However, few therapists have received training and supervised experience in incorporating spiritual interventions into their work. This article briefly addresses the purpose and prevalence of Christian spiritual interventions and proposes a series of progressive legal and ethical decision-making steps to improve therapists' skills in incorporating such interventions into psychotherapy. The initial steps include an assessment of the therapist's role, the setting of therapy, and the presenting problem of the client. Additional steps include obtaining informed consent, evaluating a therapist's competency, maintaining professional and scientific responsibility, respecting the client's religious values, documenting the use of spiritual interventions, making appropriate financial arrangements, and promoting the welfare of the client.

Religious issues in counselling: are Australian psychologists “dragging the chain”?

“…While some psychologists would argue that an explicit approach is appropriate in the therapeutic context, provided that certain guidelines are followed (e.g., Yarhouse & VanOrman, 1999), others believe that religious interventions fall within the domain of clergy or spiritual directors rather than psychologists (e.g., Tillman, 1998). Before using a religious intervention, it is important for the psychologist to consider the role he or she is to play in therapy, the setting of the therapy, and the reason the client is seeking help (Chappelle, 2000). Is it the psychologist's role to adapt therapeutic techniques to the religious framework of the client?…”

“…However, if the goal is to provide best practice for the client, a range of implicit and/or explicit therapeutic strategies may be appropriate. Chappelle (2000) discusses ethical considerations in dealing with religious issues and provides some excellent guidelines regarding the appropriate use of spiritual interventions in therapy.…”

“…It may be better still if the request for religious interventions comes from the client. Chappelle (2000) further argues that "a therapist should obtain informed consent each time he or she wishes to use a particular spiritual intervention inside (as well as outside) of therapy" (p. 48) and that the counsellor should also inform the client of alternative treatment methods. There may also be times when a religious intervention may be contraindicated.…”

“…There may also be times when a religious intervention may be contraindicated. For example, Chappelle (2000) suggests that it is unwise to use spiritual interventions with clients who are actively delusional or psychotic. He also argues that the use of spiritual interventions should be documented and that such interventions should only be used if the therapist can "justify their use with a sound rationale or integrate them with additional interventions that are scientifically proven to be effective" (p. 50).…”

“…If therapists attempt to use religious interventions in therapy, yet are not competent in the use of those techniques, they may be in breach of APS and APA codes of ethics. Indeed, therapists are not to practice outside the boundaries of their own competence (Chappelle, 2000;Johnson et al, 2000), but are to "obtain the training, experience, consultation, or supervision necessary to ensure the competence of their services, or they make appropriate referrals" (APA, 1992, p. 7). The issues of referrals and training will be dealt with in the next two sections.…”