The myth of spirituality

Abstract

This article is designed to open a conversation about the place of spirituality in social work, highlight possible ethical issues, and question whether spirituality, as defined by social work and popular culture, is an immutable part of human development. Additionally, the role of social work in conducting spiritual assessments and interventions is specifically challenged, along with examples of how the misuse of spirituality can harm clients. The article also suggests that the profession would benefit from adopting an evidence-based concept of spirituality and establishing accountability standards. Findings: Until more is known about spirituality, social workers may want to consider: (1) placing a moratorium on using and developing spiritual assessment instruments until the concept can be accurately defined; (2) omitting words linked to religious symbols such as soul, anointing, blessing, etc. in social work practice; (3) conducting spiritual screenings rather than complete spiritual assessments, and (4) referring clients with spiritual questions or wanting spiritual support to experts known not to blame or harm clients and trained in the specific area of concerns expressed by the person. Applications. The time has come for social work to establish ethics, accountability, and limitations on the practice of spirituality.

The quiet acceptance of spirituality

With little debate, social workers seem to have accepted that spirituality is part of the profession's mandate. This is particularly the case in North America but has also been addressed internationally (Furman et al., 2007). For example, a survey in Britain and Norway found that UK workers favor including spiritual practices in professional services more than Norwegian social workers. Equally important is the researchers’ finding that the role of spirituality in social work demands more research and empirical data (Zahl et al., 2007). Direct endorsements, university teachings, journal articles, and silence from evidence-based practitioners have led to the acceptance and normalization of spiritual assumptions. The opening sentence of a recent textbook declares that there is now a consensus that spirituality should be included in all social work (Boynton & Vis, 2020). When and how this consensus was gained is not articulated. Voices countering this advocacy are difficult to find.

The purpose of this article is to open a conversation about the place of spirituality in social work, highlight possible ethical issues, and question whether spirituality as defined by social work and popular culture is an immutable part of human development. When combined with social work practice, one can hypothesize that misuse of spirituality may harm vulnerable clients. Crisp (2020), an advocate for infusing spirituality into practice, cautions that social workers are responsible for safeguarding clients from experiencing harm from spiritual interventions. He further warns that spirituality cannot necessarily be associated with positive mental health, and blending culture and spirituality has the potential for fostering oppression (Crisp, 2020). In actuality, only limited research addresses the question of spirituality and potential for harm to clients. Nonetheless, the existing studies illustrate why factual information and investigations are required before social work embraces spirituality.

Positive statements about spirituality and spiritual assessments are found in numerous social work textbooks and publications (Canda et al., 2004; Kvarfordt & Sheridan, 2007). A human behavior book co-authored by this writer includes spirituality as part of a person's psychological maturation process. Between 2016 and 2021, Social Work Abstracts lists approximately 69 articles linking spirituality directly to social work practice. Many publications connect spirituality with positive health, internal wellbeing, and developmental actualization. However, they seldom identify potentially harmful aspects of spirituality, how it is measured across populations, or the qualifications required for assessing spiritual life. In addition, across disciplines, advocates identify spirituality as an essential element of human development (Carroll, 1998; King & Roeser, 2009).

Advocacy for spirituality

Professionals are not only supporting spiritual concepts but also persuasively advocating for infusing more spirituality into social work education and practice including conducting spiritual assessments and interventions (Canda et al., 2004; Furman et al., 2004; Kvarfordt & Sheridan, 2007). Briefly, spiritual assessment is generally defined in the literature as a systematic method for gaining information, data, and knowledge about a client's spiritual beliefs, practices, and perspectives. The assessment is thought to provide a foundation for employing spiritually oriented, traditional, or nonspiritual interventions (Hodge & Holtrop, 2002). It is even more difficult to determine exactly what constitutes spiritual interventions. They are either left undefined or broadly described as methods having a religious, spiritual, coping, or existential sense of meaning orientation (Coholic, 2012). Additionally, traditional interventions such as mindfulness and genograms that specifically target spiritual dimensions are also considered spirituality interventions (Hodge, 2011; Hodge & Holtrop, 2002).

At the same time, there is little agreement or evidence as to what models of spirituality fit within a social work curriculum (Watson, 2000). One justification for mandating spirituality assessments cites the Joint Commission on Accreditation of Healthcare Organizations requirement for a biopsychosocial-spiritual patient assessment (Hodge, 2006). However, this is not a specific endorsement for social workers to perform a spiritual assessment. In practical terms, it sanctions all helping professions to screen and ask patients if they would like to receive ministerial or spiritual assistance. In hospitals, spiritual assessments and interventions are often left to appropriately trained spiritual professionals (Anandarajah, 2005). In addition, spiritual assessments in medical centers often focus on religious beliefs or faith rather than more broadly defined spirituality (Crisp, 2020). Advocates also rationalize that spirituality is a natural part of social work because spiritual and religious beliefs appear across cultures (Graham et al., 2007). There is no question that varying forms of spirituality are found in most populations. However, the universality of beliefs is not evidence for inclusion within the profession's practice. There was a time when social work across the western world taught that either mothers or family communications caused schizophrenia. After decades of blaming parents in general and mothers, specifically, research proved the theories and interventions to be wrong (Woo & Keatinge, 2008).

Today, un-replicated studies employing accidental samples are used to advocate for increasing social work's involvement in spirituality (Britt et al., 2022; Dworsky et al., 2016; Gardner, 2020; Hodge, 2011; Loue, 2017; Wnuk, 2022). A 2006 study found that experienced agency workers and Muslim social work students viewed spiritual interventions as more appropriate than the overall social work student sample (Gilligan & Furness, 2006). From these findings, the researchers concluded a distinct need for educators and practitioners to focus more on clients’ and colleagues’ religious and spiritual beliefs. The reported data does not necessarily support this finding (Watson, 2000). An alternative interpretation could be that the younger students are more in touch with cultural changes. Additionally, neither the scope of spiritual interventions nor the qualitative meaning of religious and spiritual beliefs was addressed. However, the article did state that it was inappropriate to recommend interventions that advocate spiritual forgiveness, penance, healing through touching, or exorcism.

Unfortunately, this moratorium is not shared across the social work spectrum (Green, 2022). The more significant problem with this and similar studies is that it is assumed that social work spiritual assessments and interventions are warranted because people have spiritual beliefs. No study over the past ten years has questioned or tested this assumption. If we assess and conduct interventions, there is a responsibility to empirically study spirituality's legitimacy within the profession. The importance of spirituality research is underscored by new findings that a decline in mental stability rather than emotional improvement may follow spiritual explorations (Pargament & Exline, 2020). Leaders within the spirituality movement have called for improved research identifying which problems and client groups benefit from spiritual interventions (Graham et al., 2007). However, the preponderance of studies appears to have been built on the assumption that spirituality is a helpful human trait. A review of social work spirituality textbooks found that the writers start with a supposition that spirituality belongs in social work practice (Crisp, 2020). Considering these assumptions are not tested in research, advocacy, and academic arguments, it is predictable that positive outcomes will be discovered. Therefore, it seems fair to question whether spirituality studies represent self-fulfilling prophecies and beliefs.

Interest in spirituality has spurred the founding of organizations dedicated to increasing spiritual concepts, methods, and interventions into social work practice. The Canadian Society for Spirituality and Social Work states that the organization is dedicated to incorporating spirituality in social work practice, education, and research (Canadian Society for Spirituality and Social Work, 2022). The Society for Spirituality and Social Work similarly aims to disseminate spiritual practice and policies within the social work profession (The Society for Spirituality and Social Work, 2022).

Spirituality defined

Spirituality appears to be a transcendental internal experience and belief system that varies from person to person (Boynton & Vis, 2020; Senreich, 2013; Watson, 2000). Many definitions are all-inclusive, while others, especially those from religious organizations, have more restrictive parameters. However, whether inclusive or exclusive, these definitions are equally abstract. The lack of specificity invites individuals to self-define spirituality. A social work blogger writes that there is a difference between religion and spirituality. Religion is portrayed as rule-bound, while spirituality is focused on connections beyond oneself. The blogger further states that, unlike religion, spirituality requires no rituals but is an introspection into the soul and human spirit (Green, 2022). It is likely that religious leaders may disagree with this conceptualization. Nonetheless, the blogger's point of view identifies questions that social work needs to address. When are beliefs considered spiritual? If boundaries are overly broad, then everything, and yet nothing is spiritual. It is difficult to determine the meaning of terms like “soul” and “human spirit.” The social worker can always ask what the terms mean to the client. However, a client's response may not portray the individual's understanding and depth of personal spiritual activity, commitment, and dedication (Watson, 2000). The ability to define concepts is only one dimension of spirituality. It overlooks the role context and emotions play in a person's perceptions, beliefs, and understanding at a particular point in time.

A notable problem with spirituality is the lack of an agreed-upon measurable definition. In addition, it can be debated whether spirituality is an individual or group/community construct. An ethnographic study of Chicago's urban American Indians found that sacred practices served as a conceptual anchoring to their tribal identity. Their beliefs were a means of maintaining community and cultural connections rather than individualized belief systems (Suzukovic, 2011). Standard spirituality definitions include concepts of individual beliefs around a god or guiding inner spirit that fosters a sense of meaning, purpose, life priorities, morality, and a drive for loving human connections (Canda & Furman, 2010; Derezotes, 2005; Hodge, 2001; Zastow, 2012). Religious definitions include similar existential concepts but often speak specifically to the importance of sacred texts, rituals, and a relationship with a more defined God (Morgan et al., 2008). Social work's early history strongly and openly linked spirituality with Christian theology and moral beliefs (Graham et al., 2007). Historians point out that even Mary Richmond, credited with secularizing social work, was guided by Christian teachings and values (Graham et al., 2007). The early charity organization leaders wanted social work to base welfare policies and practices on a liberal religious doctrine and enlightened science (Leiby, 1984). Today, scholars are attempting to develop a universally accepted spiritual perspective. However, finding the balance between a sufficiently specific yet all-accepting definition of spirituality has proven elusive.

One highly inclusive definition completely accepts a client's subjective beliefs about life and the universe's unanswerable questions, including mystical and psychic experiences (Senreich, 2013). We always understand that mystic beliefs are experienced as real by the client. However, it is less known whether it is healthy to reinforce these cognitions and emotions. Additionally, abstract concepts create communication problems. People within the same spiritual group can use critical terms differently. Consider, as an example, the numerous perspectives of the holy trinity found within Christian communities (Tuggy, 2021). Commonly used religious terms can have different meanings and importance from person to person. The lack of a unified definition places spirituality research in question. Abstract ideas are difficult to operationalize and make it impossible to control intervening variables.

Moreover, the very selection of a definition places the researcher in danger of running into design bias. Personally, deeply-held beliefs can influence item selection and methodology (Smith & Noble, 2014). The lack of a unified concrete definition also increases the possibility of selection bias. For example, most religious and spirituality research focuses on people raised in Judeo-Christian cultural traditions (National Center for Cultural Competence, 2022). Determining inclusion and exclusion rules for a broadly defined spirituality study is challenging. One must also question whether a person's level of spirituality is measurable (Bask, 2003). Considering the intrinsic nature of spirituality, researchers must question whether practiced rituals, meditation, and other internal activities or voiced sincerity is a measure of an individual's depth of spirituality. Operationalizing low, moderate, or high levels of spirituality is encumbered with problems. Our inability to measure different amounts of spiritual dedication across participants ensures that reducing selection bias flaws within research designs will be difficult. More importantly, the inability to operationalize spirituality creates an environment that fosters competing professional values. Without limits and unassailable values, the profession has the potential to allow uninformed social workers and opportunists to harm clients. While much of society has moved away from demonic possession and spiritual witchcraft, there is no reason to believe that the gap might not be filled with modernized pseudoscientists and self-anointed spiritualists.

Can spirituality harm clients?

Social work supporters of spirituality assert that the obligation to assess the whole person also means there is an ethical duty to conduct spiritual assessments and interventions (Morgan et al., 2008). Such ethical discussions often are uni-directional in support of integrating spirituality into social work practice (Canda et al., 2004) yet guidelines for helping licensing bodies, courts, and associations determine when a social worker has committed unethical spiritual assessments or interventions have not been widely discussed nor robustly developed. For example, Codes of Ethics for Social Work in Canada, the United States, and the United Kingdom identify practice principles emanating from core social work values such as social justice and professional integrity (British Association of Social Workers, 2021; Canadian Association of Social Workers Code of Ethics, 2005; National Association of Social Workers, 2021). These practice principles may acknowledge the importance of a client's spiritual orientation, such as the standard for holistically recognizing all areas of a client's life, including spiritual dimensions (British Association of Social Workers, 2021). However, they do not address the values and standards expected from workers engaging in spiritual practices. Spirituality for the client and worker is highly personalized and seen by some as a higher value system. In light of possible conflicting belief systems, we must consider whether existing codes of ethics protect clients from ill-directed spiritual interventions.

In one article from the Simmons School of Social Work's Practice Digest, the authors stress that conducting a spiritual assessment signifies cultural competence and ethical responsibility (Darrell & Rich, 2017). The sanction for such an ethical declaration and strong links to cultural competence is not automatically self-evident. Clients from fundamentalist, regional, non-Christian, or Indigenous communities may give little or no authorization for outside professionals to conduct spiritual assessments and interventions. Moreover, no profession-wide accepted spirituality evaluation instruments exist.

Additionally, no guidelines address whether a social worker is more responsible for upholding social work licensing and association standards or spiritual ethics. When a professional believes a client's soul is in danger of eternal damnation or spiritual activities will significantly change a client's health, which belief standards or canons take precedence? The obvious answer is that the social worker starts where the client is, equalizes the power differential, and allows the client to self-determine personal spirituality needs. Actualizing such a plan when the professional has unshakeable beliefs is difficult.

Social work ethics are also ambiguous on practices such as praying, anointing, or advising clients to receive prayer and anointing. Without spiritual guidelines and ethics, each social worker can determine their individualized meaning of spiritual practice. Therefore, if a client asks, “Am I going to hell?” and the professional strongly believes that is the state of the person's soul, a clinician currently has the right to confirm the client's fear. When a social worker spiritually believes in the curative property of crystals, and a client's health continues to deteriorate despite medical attention, is the worker sanctioned, even obligated, to recommend for the client to buy and use crystals? One can argue that introducing spiritual pathways or alternative health practices is simply rephrasing what a struggling client is searching for and trying to articulate. That is an understandable subjective interpretation and perhaps partially supported by existential theory (Frankl, 2014). However, it is debatable whether such exploration and guidance are applicable across the wide abstract range of spirituality.

Spiritual leaders have alluded to ethical questions of this type without resolution. One group of authors suggested that fundamentalist religious beliefs have the potential to harm clients. The writers also questioned whether alternative practices like yoga and bodyworks (e.g., massage and breathing techniques) belonged in social work practice (Graham et al., 2007). However, declaring fundamental religious theology as out-of-bounds for social work spirituality is also problematic. Drawing the line as to where a fundamentalist doctrine or belief is accepted or rejected is highly subjective. Nonetheless, we risk ritualistic experimentation, mysticism, and indoctrination without an agreed-upon spiritual definition and code of ethics. In an effort to address ethical dilemmas of spiritual practice and link spirituality with evidence-based interventions, one expert recommends that social workers: (1) honor client preferences; (2) knowledgeably use research; (3) maintain clinical proficiency; and (4) know and apply correct cultural competencies (Hodge, 2011). There is no doubt that these are worthy general guidelines, but they fail to address the lack of standards for spirituality practice or protect clients.

Spiritual assessments and interventions, like all therapies, have the potential for harm. This is especially true if the modality is not professionally presented and personalized to the client's specific needs, mental capacity, perceptions, and life experiences. Unfortunately, how spiritual methods are best presented, which clients they are used with, and who is harmed by focusing on spirituality have not been adequately investigated. A primary argument of this article is that social work has given very little consideration to how we minimize the incorrect use of spiritual practices. Nonetheless, readers have a right to ask whether the proposed harm is realistic or a bias against spirituality. There are several ways to address the reality of harm and spiritual assessments and practices. First, in light of the lack of research, universal definitions, and proven interventions, an acceptable answer to the question of whether spirituality can harm people is that we do not know. Therefore, the possibility of harm is a valid concern and hypothesis deserving investigation.

One can also postulate that spiritual assessments and interventions may create ethical dilemmas and emotional pain for some clients. Spiritual references in therapy could cue vulnerable individuals to ruminate about their place in the spiritual world or question whether symptoms are a test of personal sincerity and dedication. We also have no idea whether spiritual assessments trigger guilt and fear that symptoms are punishment for lack of faithfulness to religious teachings. Moreover, research has not determined if self-blaming, hopelessness, feelings of unworthiness, or self-damnation occurs when spiritual interventions fail to bring relief. There is some evidence that spiritual assessments and interventions, rather than causing mental problems, may intensify previously hidden or mild symptoms (Greenberg & Witztum, 2001).

Spiritually oriented social workers often include mindfulness and other holistic interventions like yoga, meditation, and bodyworks into their practice (Coholic, 2022; Smit & Vis, 2022). There are indications that some mindfulness can increase concentration, emotional stability, acceptance, positive thinking, and other forms of psychological wellbeing (Keng et al., 2011). These practices have become common among spiritual and secular professionals and are often employed to teach clients to focus on and accept the realities of the present moment (Johnson, 1989), but it is difficult to ascertain if the methods are employed as add-on therapies or pathways to a spiritual experience. How these interventions may relate to gaining a spiritual experience or insights is not apparent. The lack of clarification may occur because the interventions appear nonthreatening. However, new research indicates that while mindfulness reduces guilt, it can deplete a person's generosity toward others (Hafenbrack et al., 2021). The loss of kindness and an amplified inward perspective can stand in the way of needed socialization. In addition to behavioral changes, studies have also reported adverse psychological events from meditation or mindfulness (Britton et al., 2021; Schlosser et al., 2019). There is also evidence that mindfulness and meditation can retraumatize and trigger sleep problems (Britton et al., 2021). A systematic review of meditation and mindfulness research completed over the past 50 years found that the methods can trigger anxiety, depression, stress, depersonalization, hallucinations, and recall of traumatic events (Farias et al., 2020). The authors also found that adverse events from meditation and mindfulness can occur in individuals with and without a history of mental disorders. These findings, however, must be placed within the context of research limitations. Many of the reviewed studies had methodological problems and consisted of small samples. It is equally important to underscore that the interventions did not negatively affect a majority of participants. Nonetheless, these reports remind us that secular and spiritual therapy methods can injure clients. The studies also point out that it is difficult and almost impossible to identify which clients will benefit from spiritual interventions and who will suffer injuries.

When symbols such as a “higher power,” inner peace, healing, channeling, blessing, or anointing are linked with spiritual assessments and interventions, vulnerable clients are unknowingly in danger of developing false memories (Duke, 2018; Shaw, 2016; Tomasello, 2018). Fragile clients, for example, may internalize a therapist's positive or negative spiritual experiences and incorporate them into their memory. As the therapist's testimonials are recalled, a mental transfer can occur, switching the ownership of the experience from the therapist to the client. Obviously, this is not a common occurrence. The difficulty is that we cannot predict how clients incorporate the information. Even when people are not in crisis, there is a propensity to immediately accept or reject what is heard without scrutinizing the information. This is particularly true for individuals facing mental health issues. Overly practiced information and unchallenged pronouncements from admired clinicians can develop into cognitive false beliefs and memories. There is no doubt that this phenomenon can occur from many forms of therapy. However, the possibility of spiritual methods causing false memories has received little attention. Centuries of religious and philosophical teachings have created what cognitive scientists refer to as automatic responses (Taylor, 2015). Automatic thoughts occur when information is overlearned, and responses arise without processing or critically examining the immediate circumstances and social context. We see a church steeple, and as a result of cultural exposure, we automatically associate the belfry as a symbol holding spiritual meaning.

One can argue that culturally, spirituality suggests a relation between religion, mysticism, spirit worlds, judgment, consequences, and internal and external guidance (McSherry & Cash, 2004). The concept of spirituality is so elastic that it is difficult, if not impossible, to know how a social worker's spiritual communications are perceived and processed by a client (Bask, 2003). Moreover, we live among overt and invisible societal symbols and meta-communications that signal the authenticity and essentialness of spirituality. Cultural symbols instill spiritual ideas and perspectives even in those who have never practiced religious traditions. Therefore, as a client's self-defined beliefs mix with cultural perceptions and interact with suggestions from a professional, the danger of false memories increases (Shaw, 2016).

There are some neurobiological difficulties that may increase client susceptibility to harm from spiritual assessments and interventions. For example, individuals with depression or anxiety may experience injuries when spiritual assessments or practices are incorrectly applied, or the social worker misinterprets how the client receives and processes information. We know that depression can slow the brain's frontal cortex and disrupt problem-solving, discovering alternative solutions, concentration, and similar tasks (Price & Drevets, 2013). As the frontal cortex slows, depressed and anxious clients often experience difficulty focusing, interpreting information, and ruminating. Additionally, disruptions of social-cognitive information processing can result in fragmented client communication and reduced comprehension of instructional or psychoeducational conversations (Woo & Keatinge, 2008). Furthermore, as the frontal cortex functioning slows and depression escalates, the possibility for a client to misconstrue a social worker's spiritual messaging increases. Correspondingly, misconceptions shift one's thinking, increase ruminations and selective listening, and intensify feelings of grief, self-blame, or hopelessness.

Anxiety involves numerous parts of the brain's limbic system but is predominantly explained by the amygdala and hippocampus. During periods of anxiety, the amygdala serves as an alert system, and the hippocampus selects the environmental cues to place into memory (Vermetten et al., 2002). The amygdala sends unusually fast chemical messages of danger to clients with an anxiety disorder, while the hippocampus creates memories of external hazards and internal distraught cognitions and emotions (Cain et al., 2013). For vulnerable clients, misdirected spiritual practices may trigger internal scans that link new spiritual symbols to old fears or generate new anxieties around self-worth. In addition, because of the interaction between brain activity and cultural learning, social work must consider whether spiritual practices can complicate formulating a diagnosis. If spirituality is completely self-defined, it becomes harder to separate pathological religiosity from a dedicated unique lifestyle. More importantly, spiritual assessment instruments are psychometrically weak and cannot measure neurobiological and social interactional processes. Undefined variables or items with multiple meanings will not produce reliable and valid measurements (Bask, 2003). Within the spirituality community, there is an awareness that spiritual assessment instruments must be psychometrically improved. A mixed methods study tested the validity of a set of assessment tools for Native Americans (Hodge & Limb, 2011). While the findings cannot be generalized because of sample size and sampling methods, the study represents efforts to make spirituality more evidence-based. Furthermore, more recent literature also recognizes that evidence-based spirituality assessments with Indigenous communities cannot be wholly achieved without improved instruments developed in a trusted equitable partnership with elders and knowledge keepers (Vis & Boynton, 2022).

Is spirituality in social work a myth?

Before discussing myths and spirituality, a word of clarification is needed. The author is not arguing that there is no God, higher power, or benefit from spiritual beliefs. Answers to these questions are highly personal and widely varied from person to person. Therefore, spirituality may be not only undefinable but also person-dependent. Moreover, if we cannot account for intervening variables and estimate how much variance is explained by spiritual practices, it is reasonable to ask if spirituality belongs in social work. Additionally, as an evidence-based profession, there is an obligation to research how spiritual beliefs are formed and if spirituality is an essential part of human development. Throughout this section of the article, hypotheses are suggested for studying the human experience of spirituality. The hypotheses are pathways for future exploration rather than definitive answers.

Two major spirituality myths permeate the social work literature. First, it is implied that even though spirituality cannot be defined, we know what it is. Professional beliefs of this type clash with the research rule that if a variable cannot be defined, it cannot be measured, and if it cannot be measured, it cannot accurately be studied. Nevertheless, it must also be acknowledged that an inability to measure a concept does not disprove that it exists. Additionally, the fact that people worldwide have spiritual beliefs and experiences does not eclipse the research axiom. One can argue that spirituality is an issue of faith, belief, and personal experience that cannot scientifically be explained or measured. However, the obvious counter to this perspective is that spirituality essentially belongs outside of social work and with professionals who spend a lifetime studying the topic. This should not be interpreted as meaning that spiritual beliefs cannot be helpful to many people. The goal is not to challenge individual spirituality. However, we are interested in increasing accountability, preventing assessments based on unproven assumptions, and acknowledging the myth that social work knows what spirituality is and understands the phenomenon. Much of social work validates an open boundary spirituality concept. As a profession, we need to know the limits of spirituality. Do we, as an example, accept all forms of nonreligious nonprescribed secular spirituality, or must they conform to certain guiding principles, values, and purpose? Logically even non-religious spirituality requires, at a minimum, a loose structure. Answering these and similar questions will help define spirituality and move it away from untested assumptions and mythology.

The second myth social work must wrestle with is our acceptance that spirituality is vital to human development. Removing spirituality as an essential part of developmental theory does not negate its significance, influence, effect, and meaningful help it provides to countless people. Certainly, spirituality provides a means for individuals to stand outside their neurobiological, social, and experiential knowledge and reflect existentially on self-discovery, unanswerable questions, and their relationship with eternity and the universe (Anonymous, personal communication, March 14, 2023). This emphasizes an internal process and spiritual quest rather than scientific linkage with human development. It also moves spirituality away from psychometric and research rules and into the domain of religious and spiritual leaders.

Advocates describe spirituality as a developmental gestalt encompassing not only the unknown secrets of life but also biology, cognition, and emotion (Boynton & Vis, 2020). The argument of whether spirituality is a crucial component of development goes back to theories conceptualized by Freud and Jung. The two separated in part because Freud rejected Jung's emphasis on spirituality. Modern-day professionals have continued searching for evidence that spirituality is vital to the developmental process. Attempts have been made to link spirituality to Piagetian and Eriksonian stage concepts, hierarchical complexity models, and other theories (Day, 2017; Tate & Parker, 2007). Spirituality stage research has relied chiefly on observations. In addition, the studies fail to define what constitutes growth or developmental change, structural transformation, or hierarchical achievement (Commons & Pedder, 2005). However, research methods employing a model of hierarchical complexity and mathematical analyses report success in measuring changes in abstract developmental stage growth (Commons & Richards, 2003). These complex research methods support future explorations into the relationship between spirituality and human development (Commons & Richards, 2003; Day, 2017). Nevertheless, it remains unclear how any investigation of relationships between spirituality and development controls for the multidimensional and changeable variables relating to biological, psychological, and cultural influences.

Describing spirituality as a developmental domain has primarily gained acceptance through declaration, limited research, cultural popularity, and experiential confirmation. There is no indication that if individuals choose not to accept spirituality, they face mental deficits that evolve into, if not despair, emotional emptiness. Furthermore, newer studies indicate that the results of raising children in religious versus secular homes, when examined globally, is very mixed (Bartkowski et al., 2019; Bornstein et al., 2017). Homes with and without spiritual emphases have positive and negative effects on child development. We cannot use spirituality to predict moral or behavioral development. Spirituality as a critical component of human development is an assumption that has gained mythical status without significant evidential documentation.

A popular book hypothesized that spirituality emanates from an adaptive “God” gene that evolved in humans from centuries of continuous religious messaging (Hamer, 2005). The theory gained little scientific support. However, the extent to which spirituality has evolved as a social construct deserves consideration. Removing myths about spirituality does not take humanity out of social work but instead makes our profession more accountable and prevents assessments based on assumptions. We know that spirituality has aided people with significant health and mental health disorders (Mohandas, 2008). What is lacking is for the profession to empirically understand these phenomena rather than continuing to validate a boundary-less concept of spirituality. To protect clients and social workers, we must understand the limits, strengths, and deficits of spirituality.

Conclusion: Reframing spirituality

This article does not suggest that spirituality is not real, helpful, and significant for any given individual. It is argued that spirituality is not measurable and cannot currently be considered an essential domain within human development. In addition, the definition and practice of spirituality are beyond the scope of social work and best left to professions trained to deliver spiritual assistance. Social work could conceptualize spirituality as a highly individualized, culturally shaped belief system that has differential meanings from one person to another. When framed in this manner, spiritual screening is nested within a complete biopsychosocial assessment rather than a separate, equally weighted evaluation. The profession understands and respects that an individual may or may not have strong religious or secular spiritual beliefs. Therefore, to fully understand a person's worldview, social workers will want to ask clients if they have specific spiritual beliefs or practices. However, as an example, if the client states, “I pray almost daily, but do not really find an answer.” A social worker, among other things, could reply, “if exploring your spiritual life is helpful, I can connect you with an expert. That person can guide your spirituality search, and we will continue focusing on your depression.” If the client responds positively, the worker will want to ask additional case management clarification questions. We only gather enough information to assure that the referral is made to an ethical, spiritual counselor who can skillfully address the clients, concerns, cultural history, beliefs, and temperament. Therefore, a social work spiritual screening may help clients state their belief systems and self-determine whether spiritual assistance would be helpful. This perspective also allows carefully researched methods of stress reduction to be taught as a support for improving problem-solving. Uncoupling these interventions from spiritual practices, self-discovery, or connection with a higher power removes unmeasurable mystical elements from social work interventions.

We know humans must have water and food, or they will die. Developmental difficulties occur when an infant or child is isolated. However, we do not know that individuals reach self-fulfillment only once an appropriate state of spirituality is gained. Furthermore, no professional can assess how much and what type of spiritual practice is healthy for any one person. Until more is known about spirituality, social workers may want to consider:

placing a moratorium on using and developing spiritual assessment instruments until the concept can be accurately defined;

omitting words linked to religious symbols such as soul, anointing, blessing, etc. in social work practice;

conducting spiritual screenings rather than complete spiritual assessments, and

referring clients with spiritual questions or wanting spiritual support to experts known not to blame or harm clients, and trained in the specific area of concerns expressed by the person.

As demonstrated throughout this article, existing social work ethics and sanctioning organizations do not specifically address the profession's definition, role, values, and responsibilities in the delivery of spiritual practices. In addition, the issue is complicated by the overlap between religious and nonreligious practitioners, and the countless existing spiritual belief systems. Together these elements prevent the formation of clear enforceable social work values that significantly reduce the risk of harming clients. The time has come for social workers to have serious discussions, not about the worth of individual spiritual beliefs but about the meaning and practice of spirituality within the profession.