Walsh Presents Ruth Irelan Knee Lecture on Spirituality in Social Work

Froma Walsh, the Mose and Sylvia Firestone Professor at SSA, delivered this year’s Ruth Irelan Knee Lecture on Spirituality in Social Work on November 9, 2006. The lecture, entitled “The Spiritual Dimension in Suffering, Healing, and Resilience: Clinical Theory and Practice,” called on social workers and other clinical practitioners to become more aware of how spiritual resources can contribute to positive outcomes for their clients.

Walsh began by noting that the concept of spirituality “took too long to come to mental health.” Spirituality was “not to be talked about, not to be studied, and certainly not to be talked about” as a subject in academic research or clinical practice. Now that social work has turned much more to a bio-psycho-social orientation, Walsh notes that this could be even better expressed as a bio-psycho-social-spiritual orientation.

Walsh emphasizes that spirituality is one of the factors that can increase client resilience, which she defines as the ability to “withstand and rebound from disruptive life challenges, strengthened and more resourceful.” She notes that by the 1970s virtually all measures of spirituality were significant in predicting recovery from trauma. This encourages clinicians to look beyond the therapeutic dyad to the interconnections and relationships that also impact wellbeing.

The conceptualization of spirituality in social work used by Walsh is influenced by family systems theory, family stress theory, and the family development life cycle framework. She also points to the recent paradigm shift in looking at post-traumatic stress as post-traumatic growth. Individuals and families identified as at risk for negative outcomes, those recovering from traumas or loss, or coping with multiple ongoing stressors, can all benefit from relational resilience. This concept looks at the potential for endurance, healing, and positive growth through familial, communal, cultural, and spiritual connections.

Walsh notes that the principal domains of family life, such as belief systems, organizational patterns, and communication processes, all have a spiritual dimension. Belief systems are rooted in a cultural worldview and can predict how clients both define their problems as well as how they see possibilities for solving or ameliorating them. Walsh points out that the stereotypical American idea that “seeing is believing” is very different from how other cultures have formulated similar topics; she points to a Talmudic adage (“we do not see things as they are; we see them as we are”) as a salient example.

Spirituality also allows for the possibility for meaning-making beyond the medical model of practice. Clients can appraise their situations and reach points of adaptation and recovery beyond merely establishing control of their symptoms. Even the highly victimized learn they have the power to impact the crisis they experienced and gain a new sense of coherence and meaning. Their outlook can become more helpful and give them the incentive to master the possible, taking charge of their lives and opening doors to new possibilities.

Walsh also focuses on transcendence as a spiritual resource. The ability to see beyond immediate circumstances can provide an ethical compass with larger values of purpose. This can extend to participation in some kind of faith community and lead to a sense of solidarity and connection with others. Walsh distinguishes religion as an organized belief system from the broader category of spirituality, the latter being an active investment in internal values which may or may not include religious aspects. While Freudian and empirical viewpoints discounted such concerns, there is new recognition that spirituality can be a community resource like any other. Walsh cites military chaplains as an example of a powerful therapeutic resource in an environment where regular clinical treatment may be stigmatized.

Walsh emphasizes that proselytism or therapeutic pressure to adopt spiritual practices must always be avoided, but research shows that clients often desire practitioners to inquire about spiritual issues and sometimes even to pray with them. Clinicians should also be aware that many people find spiritual strength in nature outside of formal religiosity. Walsh recommends always asking clients their own meanings of spiritual concepts; there are many counterintuitive realities regarding people's individual beliefs. While traditional religious knowledge is broad, it is often not deep, and it is always subject to individual reinterpretation.

Belief in God and regular religious practices are common among the vast majority of Americans. Research has regularly found that prayer can have a beneficial effect on everything from the cardiovascular system to brain function. Walsh notes the varied functions of prayer, from adoration of a deity to petition for divine assistance, and she notes that the majority report praying for others more than for themselves. Walsh concludes by noting that while spiritual issues have also contributed to human suffering, such as religious oppression of gays and lesbians and subjugation of women, spiritual inquiry can be a highly beneficial element of social work practice.

Ruth Irelan Knee, A.M. ’45, was a founding member of the National Association of Social Workers and one of the first psychiatric social workers. Her work across three decades helped define the role of social workers in the public sector. The Ruth Irelan Knee Support Fund on Spirituality in Social Work sponsors this annual lecture at SSA.