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Clinical counseling Issues and applications for spiritual clients. Michele D. Aluoch River of Life Professional Counseling LLC www.rolpc.org (614) 353-4157. Incorporating Spirituality Into Core Counseling Courses (Briggs & Rayle , 2005).

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clinical counseling issues and applications for spiritual clients

Clinical counseling Issues and applications for spiritual clients

Michele D. Aluoch

River of Life Professional Counseling LLC

www.rolpc.org

(614) 353-4157

incorporating spirituality into core counseling courses briggs rayle 2005
Incorporating Spirituality Into Core Counseling Courses(Briggs & Rayle, 2005)
  • Falls under the rubric of multicultural competencies and meeting the client where he/she is at
  • While most counselors recognize the value of having some awareness and training in the role of spiritual issues in counseling (60-90% in nearly all literature), very few (10-30%) state that it was any significant part of their coursework
  • “Spirituality” mentioned in CACREP standards for counseling programs
  • Falls under multicultural counseling domain in ACA Ethics- “Counselors must learn and acknowledge how their own cultural/ethnic, racial identities affect their attitudes and behaviors.”
  • AAMFT Code of Ethics: “MFTs provide assistance without discrimination on the basis of race, age, ethnicity, socioeconomic status, disability, gender, health status, religion, national origin”; “are aware of their influences”, ; “advance the welfare of the client”; “use appropriate services”
incorporating spirituality into core counseling courses briggs rayle 20051
Incorporating Spirituality Into Core Counseling Courses(Briggs & Rayle, 2005)

Questions For Clinical Counseling Students To Consider Regarding Their Own Spirituality:

1. What are your views concerning religion and spirituality?

2. How do you believe these views will affect your counseling role?

3. How will you be able to empathize with clients who have differing spiritual values than your own?

4. How will you keep your own spiritual values/beliefs from inappropriately influencing the counseling relationship?

spirituality in clinical supervision tan 2007
Spirituality in Clinical Supervision (Tan 2007)
  • 1. Intervention skills
  • 2. Assessment approaches and techniques
  • 3. Individual and cultural differences
  • 4. Interpersonal assessment
  • 5. Theoretical orientation
  • 6. Problem conceptualization
  • 7. Selecting treatment goals and plans
  • 8. Professional ethics
a christian worldview model of clinical counseling supervision bufford 2007
A Christian Worldview Model of ClinicalCounseling Supervision (Bufford, 2007)
  • “worldviews are like sand- they get into everything”
    • How we interpret events, our rationales, why conflict, etc.
    • Saying or doing good and what blesses and encourages supervisees toward professional development
    • Speaking the truth in a context of Christian love
    • Correcting supervisees with an attitude of graciousness, kindness, gentleness, and humility remembering that we once were there
    • Accurately appraising ourselves
    • Being good stewards of the gifts and talents we have
christian worldview model 2 of clinical counselor supervision allen boyer tucker 2007
Christian Worldview Model #2 of Clinical Counselor Supervision (Allen, Boyer, & Tucker, 2007)

Supervisor as teacher:

  • 1. Assess supervisees spirituality/practices
  • 2. Provide resources to supervises for integrating spirituality with clients when appropriate
  • 3. Give supervises opportunity to assess client’s spirituality
  • 4.Give supervises feedback on their attempts at integration
  • 5. Show supervises how to use spiritually integrated interventions
  • 6. Offer ongoing instruction on use of Christian clinical models.
christian worldview model 2 of clinical counselor supervision allen boyer tucker 20071
Christian Worldview Model #2 of Clinical Counselor Supervision (Allen, Boyer, & Tucker, 2007)

Supervisor as facilitator:

  • 7. Help supervises differentiate between their own and their client’s belief.
  • 8. Encourage supervises to integrate spirituality into case conceptualization.
  • 9. Discuss with supervisees the client’s religious experiences in supervision.
  • 10. Use questions to spark discussion of religious an spiritual elements in cases
  • 11. Brainstorm which religious techniques could be used by supervises in sessions
  • 12. Identify religious transference and countertransference issues that may need to be addressed.
  • 13. Talk about refer to religious leaders when necessary.
  • 14. Encourage supervisees spiritual development.
christian worldview model 2 of clinical counselor supervision allen boyer tucker 20072
Christian Worldview Model #2 of Clinical Counselor Supervision (Allen, Boyer, & Tucker, 2007)

Supervisor As Model:

  • 15. Use parallel processes to show how to address spirituality and religious issues.
  • 16. Share self disclosures with supervisees.
  • 17. Role play Christian clinical counseling approaches in supervision.
  • Internal methods for supervisors:
  • 18. Introspection, examination, and refection
  • 19.Spiritual disciplines
  • 20. Involvement with a faith community
  • 21. Prayer for clinical supervision sessions
  • 22. Prayer for client situations.
operational definitions exercise
Operational Definitions Exercise

Exercises:

Write definitions of:

Spirituality Church

Religion Heaven

God Hell

Spiritual development

Spiritual maturity

Mercy

Justice

developing an awareness of role of spirituality in the counselor s life
Developing An Awareness of Role of Spirituality in the Counselor’s Life
  • Narrative story about your spiritual journey (factors that shaped it, people/places, significant events, where you believe you are at today versus where you’d like to be/think God wants you to be, etc.)
  • Role play with different types of clients what it might be like to counsel a person from differing faith or spirituality beliefs.
  • Consider what a “holistic” approach means to you. What skills would you need to develop competencies to work with people of different ages, races, beliefs, religious, spiritual approaches?
expectations of conservative christian counseling clients
Expectations of Conservative Christian Counseling Clients

(Turton, 2004; Belaire, Young, Elder, 2005; )

  • Expected respect for their worldview and acceptance
  • Expected that religion and spirituality would definitely be included as a significant part of the counseling process. May include (determine on a case by case basis):

Moral teachings Scriptures or Bible verses Praying in Session

Listening to story of their conversion or changes from past conversion, current struggles, etc.

Hearing some thing about the counselor’s spiritual experience, moral beliefs, lifestyle, or conversion experiences

Collateral consultation with clergy pastors, or religious “authorities” that the client can relate to or is accountable to

Use “religious language” in session Use religious examples, stories, or parables

Be willing to learn about client’s personal spiritual experience, denomination, journey.

Refer client to someone who understands or can better empathically relate if n able to relate to it or understand or respect that

Accept the religious practices and rituals that are part of client’s experience.

expectations of conservative christian counseling clients continued
Expectations of Conservative Christian Counseling Clients (Continued)

What Evangelical Christians Want From Counseling

  • Prefer Non Directive Approach
  • Expect to leave the counseling session with their lives “spiritually stimulated”
  • Expect to be encouraged to apply and further Biblical understanding
  • Goal of Counseling: Closer relationship with God, more fervent prayer life, a lifestyle that is consistent with traditional Biblical values, direct discouragement and challenging of lifestyle and behaviors inconsistent with the values they are stating they espouse
  • Overall: Less likely to attend counseling of the counselor is not a Christian and does not share their religious orientation (95%); Religious/spiritual beliefs affect my daily decisions (98%)
why spiritual assessment o akes raphel 2008
Why Spiritual Assessment?(Oakes & Raphel, 2008)
  • Enhances the counselor’s empathy and sensitivity toward the client’s unique experiences
  • Can support the counselor’s diagnosis about healthy or unhealthy spirituality
  • Can help the counselor identify outcomes that would be considered healthy spiritually for the client
  • Can help adapt counseling interventions personally to the spiritual needs and background of the client
doing a clinical counseling assessment incorporating spirituality richards bartz o grady 2009
Doing a Clinical Counseling Assessment Incorporating Spirituality(Richards, Bartz, & O’Grady, 2009)
doing a clinical counseling assessment incorporating spirituality
Doing a Clinical Counseling Assessment Incorporating Spirituality

12 Sample Questions:

1. Do you wish to discuss spiritual issues in counseling when relevant?

2. Do you believe in God?

3. What is God to you?

4. Is spirituality important to you (scaling)

5. Do you have a religious affiliation? Imp.to you? (scaling)

6.Do you attend a church, synagogue, or another gathering place?

7. How closely do you follow the teachings of your religion?

doing a clinical counseling assessment incorporating spirituality1
Doing a Clinical Counseling Assessment Incorporating Spirituality

8. How do you experience God’s guidance in your personal life?

9. Are you aware of any spiritual resources or practice sin your life that could be used to help you cope with or solve your problem? What are they?

10. Anything about your spirituality or religious community that concerns you?

11. Would you like your counselor to consult with your spiritual/religious leader if this could be helpful to you?

12. Are you willing to consider trying religious or spiritualty based suggestions from your counselor if they could be helpful to you?

doing a clinical counseling assessment incorporating spirituality2
Doing a Clinical Counseling Assessment Incorporating Spirituality

Level Two- Standardized Measures

  • Orthodoxy: How letter of the law and by the book a person is based on the traditional teachings of their religion
  • Spiritual Identity- The client’s sense of worth in relation to God
  • Level of Religious Commitment- extrinsic (to meet own ends) or intrinsic (internalized belief system)
  • God Image- The client’s perception of who God is
  • Value/Lifestyle Congruence- How consistent behaviors are with what client says he/she believes
  • Spiritual Well Being- Sense that life has meaning and purpose
  • Religious Problem Solving- 1) Self directing, 2) Deferring,

3) Collaborative

doing a clinical counseling assessment incorporating spirituality3
Doing a Clinical Counseling Assessment Incorporating Spirituality

Effective Therapy

  • Not just about technique but about the therapist’s character and relationship with the client
  • About therapist’s individual and professional awareness and differentiation
  • Includes encouraging the client’s narrative of his/her spiritual journey
doing a clinical counseling assessment incorporating spirituality4
Doing a Clinical Counseling Assessment Incorporating Spirituality

Questions To Facilitate Client’s Sharing Their Spiritual Narrative (Hoogestraat & Trammel, 2003)

  • How has your spirituality/religion influenced your life?
  • Tell me about God.
  • What does your spirituality mean to you?
  • Help me understand how you learned about spirituality/religion.
  • How do you think God view you?
  • Tell me about spiritual/religious traditions in your family.
  • How do you define spirituality/religion?
  • What spiritual/religious messages were handed down through your family?
  • Do you believe spirituality/religion causes more harm than good or more good than harm?
doing a clinical counseling assessment incorporating spirituality5
Doing a Clinical Counseling Assessment Incorporating Spirituality

Questions For Cultivating A Spiritual Autobiography

(Sociocultural Clinical perspective):

  • What is your earliest memory about God?
  • Were you raised in a religious family? What was that like?
  • What are your current religious views and beliefs?
  • How would you have described God when you were a child/teenager?
  • Who had the greatest spiritual or religious influence in you as a child/teenager?
  • What influenced your faith the most?
  • How would you describe your faith today?
  • What was your worst/best spiritual experience?
doing a clinical counseling assessment incorporating spirituality6
Doing a Clinical Counseling Assessment Incorporating Spirituality

Spiritual Differentiation

  • Client or therapist identifying and describing self as separate as distinct from others, necessary for healthy emotional and spiritual development

Higher differentiation associated with:

  • Greater capacity for intimacy
  • Allowing others to be themselves
  • Emotional stability
  • More open to discussing spirituality
doing a clinical counseling assessment incorporating spirituality7
Doing a Clinical Counseling Assessment Incorporating Spirituality

(Answer these same spiritual autobiography questions about yourself)

  • What is your earliest memory about God?
  • Were you raised in a religious family? What was that like?
  • What are your current religious views and beliefs?
  • How would you have described God when you were a child/teenager?
  • Who had the greatest spiritual or religious influence in you as a child/teenager?
  • What influenced your faith the most?
  • How would you describe your faith today?
  • What was your worst/best spiritual experience?
doing a clinical counseling assessment incorporating spirituality8
Doing a Clinical Counseling Assessment Incorporating Spirituality

Exercise: Developing Self Awareness & Differentiation as a Therapist

What are your thoughts, views, beliefs on each of the following words? Can you counsel someone with differing views from your own?

  • Abortion
  • Death Penalty
  • Drinking/Drugs
  • R-rated movies
  • Premarital sex
  • Spanking or physical disciplining a child
  • Cohabitation
  • Pornography
  • Promiscuity
  • Domestic violence
  • Dancing
  • Piercings Etc.
spirituality and development of self identity griffith griggs 2001
Spirituality and Development of Self Identity (Griffith & Griggs, 2001)

Four statuses:

  • 1) Diffusion- lack of interest in the spiritual, religion or who have a self-serving religiosity, may have had limited exposure to such or may view God as mean and unjust or nary
  • 2) Foreclosure- Learning to accommodate to the requests of others around you to gain acceptance and approval, obedience perspective
  • 3) Moratorium- Sincere self reflection and self examination, often through a time of great uncertainty which causes the person to re-evaluate things for self
  • 4) Achievement- internalized religious and spiritual beliefs, often based on a conversion experience, that which becomes a person’s core spiritual values
spirituality and development oakes raphel 2008
Spirituality and Development (Oakes & Raphel, 2008)
  • 1. Illumination- an awareness of possibilities
  • 2. Individualization- learning to esteem oneself, who am I? Who was I created to be?
  • 3. Separation- exploring and seeking answers to God questions
  • 4 Inspiration- A sense of purpose in life, reassessing how behaviors fit in with who I was called to be
doing a clinical counseling assessment incorporating spirituality9
Doing a Clinical Counseling Assessment Incorporating Spirituality
  • Differences between mental health professionals (e.g. Morrison, Clutter, Pritchett, & Demmitt, 2009; Walker, Gorsuch, Tan, & otis, 2008;Young, Wiggins-Frame, & Cashwell, 2007; Carlson, Kirkpatrick, Hecker, & Killmer, 2002): Only 25% of counselor educators deemed important to have classes on this ; very few social workers and psychologists- as little as 5-10% in some studies felt spirituality should ever be involved; 73 % of PCCs deemed important but felt not enough training; Highest percentages of training and involvement among marriage and family therapists- as much as 80-90%; Least concerned with spirituality personally or in sessions= psychologists (“80% never discussed with a client”- Walker et al.)
  • 86%of participants say spiritual training is important to develop competency in understanding dif. clients.
  • Only about 25% or less of mental health professionals in most surveys received any integration of spiritual/religious issues into their counseling training programs
  • In the counseling literature of social workers, psychiatrics, psychologists, marriage and family therapists, & counselors on surveys done in the last 10 tens asking clients “is spirituality important to your emotional healing showed 70-98% of those per survey said ‘yes’ with most percentages around 80-85% in secular and medical settings even and 85-98% among those specific requesting Christian/spiritual counselors
god images and processing counseling concerns peloso
God Images and Processing Counseling Concerns (Peloso)
  • The culture of a client’s spiritual/religious/God experience
  • Meeting the client where he/she is at may involve understanding the language, images, and ritual by which they experience God
  • Process Of Incorporating God Images:
  • 1) Conscious conflict- noticing difference between what I was taught and what I seem to be experiencing
  • 2)Time of Pause- Evaluating the contradiction
  • 3) Image/insight- coming up with some explanation or insight to explain the contradiction
  • 4)Repatterning/reframing- recomposing meaning
  • 5) Interpretation on dialogue- new insight about one’s spiritual image
god images and processing counseling concerns peloso1
God Images and Processing Counseling Concerns (Peloso)
  • Definitions Of God Image

Love---------22

Creator----------21

Always Present-----------20

Friend-----------16

Jesus Christ----------11

Strength------------11

Peaceful------------11

  • (Others: comfort, support, forgiving, a guide, compassionate, patient, a mystery, a spirit, powerful, etc.)
  • (Asses client’s definitions and experiences; Don’t assume or base on your experiences or God concept
god concepts based on childhood experiences dickie ajega kobylak nixon 2006 deroos 2006
God Concepts Based on Childhood Experiences (Dickie, Ajega, Kobylak, Nixon, 2006; DeRoos, 2006)
  • For both men and women mother or father nurturance led to self esteem or self reassurance
  • Differences- Girls whose parents used power oriented discipline (yelling, threatening, spanking) saw themselves, parents, and God as less powerful and less nurturing but for boys power-oriented discipline was not related to self, parent, and God concepts.
  • In disruptive homes young children learn God to be a comforter and helper but they struggle with God as intimate and personal to them.
spiritual genograms willow tobin tomer 2009
Spiritual Genograms (Willow, Tobin, & Tomer, 2009)
  • For self reflection, understanding of spiritual and religious practices and family systems and multi-generational dynamics
  • Charting a spiritual family tree
rational christian therapy johnson 2006
Rational Christian Therapy(Johnson, 2006)
  • Using proven REBT- Rational Emotive Behavior Therapy (Albert Ellis) but incorporating client belief systems and spiritual worldview
rational christian therapy johnson 20061
Rational Christian Therapy(Johnson, 2006)
  • Using proven REBT- Rational Emotive Behavior Therapy (Albert Ellis) but incorporating client belief systems and spiritual worldview

Common Thinking Errors:

1. Awfulizing- ____ is awful, terrible, catastrophic or as bad as it could possibly be.

2) Low Frustration Tolerance- I can’t stand _____; _____ is too much and is intolerable or unbearable.

3) Self Downing- I am no good, worthless, useless, and utter failure, beyond hope or help, devoid of value.

4) Other downing- You are no good, worthless, useless, an utter failure, beyond hope, of no value

1) But God can never separate us from His love, Romans 8:39

2) But those who endure are called blessed, James 5:11

3 & 4) But my/others’ sin does not determine me to be a worthless person the rest of my life. I can change and turn around if not by my will power by God’s grace. My life is still meaningful and significant, Titus 3:4-7

rational christian therapy johnson 20062
Rational Christian Therapy(Johnson, 2006)

Common Misbeliefs in the Counseling Literature:

  • God must answer my prayers as I’d like them to be answered.
  • I absolutely should always be loved unconditionally by all my fellow churchgoers/Christians.
  • I ought to undeniably be obeyed by other when I quote Scriptures to defend my position.
  • I must never be judged but totally accepted as I am.
  • I must always be judged
  • If only I work hard “enough” then God will see that I deserve _____.
  • Good people should always have “good” things happen to them and “bad” people should have “bad” things happen to them. (justice perspective)
  • People should have mercy on me but they should get what they deserve (justice).
  • I must spend the rest of my life paying back for what I said, did, etc.
slide34
Beliefs Of Conservative Christians That May Clash with Traditional Counseling (Eriksen, Marston, & Korte, 2002)

Five Common Belief Systems of Conservative Christians to be Aware of in Counseling:

  • 1) Self- focusing on oneself is selfish and is a sin
  • 2) Truth- Christianity is the only true way to God
  • 3) Answers to problems- the Bible is the answer book
  • 4)Feelings-joy and peace are only acceptable
  • 5) Social issues- divorce, homosexuality, abortion are not to be participated in
  • How would you handle someone who possibly espouses any of these beliefs?
cognitive behavioral therapy incorporating prayer and scripture tan 2007
Cognitive-Behavioral Therapy Incorporating Prayer and Scripture (Tan, 2007)
  • Do the level one assessment suggested earlier to get spiritual background
  • Incorporate prayer and Scripture when appropriate
    • When Beneficial to client
    • With consistency in their worldview and self talk
solution focused counseling for clients with spiritual concerns guterman leite 2006
Solution-Focused Counseling For Clients With Spiritual Concerns (Guterman & Leite, 2006)
  • Focuses on the interpersonal exchange
  • Goal- Increasing the number of exceptions to the problem: Observations of times clients are without the problem, observations of times where the problem is more resolved (client as expert observer in his/her world)
  • What treatments are effective for whom and under what circumstances”
  • Helpful questions:
  • Was there a time you coped better?
  • How did you manage?
  • The miracle question
  • Consistent with Christian spirituality: God intervening from the future to impact the present & humans as agents in collaborative partnership with God (Frederick, 2008)
clinical counseling versus spiritual direction sperry 2003
Clinical Counseling Versus Spiritual Direction (Sperry, 2003)
  • NOT the same

SPIRITUAL DIRECTIONCOUNSELING

Spiritual assessment Psych Assessment (may include spiritual history)

Spiritual experience, DMS IV diagnosis- may be psychopathology

not psychopathology

Spiritual Transformation Symptom reduction, Increased functioning,

Personality/Character changes

Triadic Rel. Improvement Dyadic Therapeutic Alliance

Direct Advisement Therapeutic Interventions

Discernment Mutual collaboration

Spiritual Resistance Psychological Resistance

dealing with the spiritual issue of diminished hope and purpose jones 2009
Dealing With The Spiritual Issue of Diminished Hope and Purpose (Jones, 2009)
  • “taking people to the healing waters”, “Do you want to be healed?”
  • Key Questions: “What hurts?”, “What heals?”

Steps:

  • 1. perceiving
  • 2. compassion for the client’s story
  • 3. reaching out to the hurting person
  • 4. asking clarifying questions
  • 5. engaging the will- drawing on the client’s resources/strengths?
  • 6. embracing the client’s stuckness
  • 7. encouraging connectedness- behavioral goals to help the client get connected to what is spiritually uplifting for him/her
slide39
Attachment Theory and Spirituality (Reinhert, Anderson, Lewis-Hall, & Hall, 2010; Reinhert, Edwards, & Hendrix, 2009; Joung, 2006)
  • Secure or insecure
  • Often interactions with significant caregivers/guardians lay a foundation for how people see God as attachment figure (similar or directly opposite)
  • Correspondence hypothesis- if a person’s attachments growing up were secure they will be securely attached to God
  • Compensation hypothesis- A person tries to redo or undo unhealthy attachment issues with a relationship with God
the healing cycle christian group therapy hook hook 2010
The Healing Cycle: Christian Group Therapy (Hook & Hook, 2010)

Steps in group therapy:

  • Grace, Safety, Vulnerability, Truth, Ownership

Grace- all need to know God’s unconditional love kindnes who acknowledge their need fro Him.

  • Group members model the heart attitude of comfort, mercy in the face of brokenness
  • I what ways have you experienced the grace of God in the midst of your brokenness?
  • In what ways have you experienced grace from others?
  • What are some of the barriers you faced? How did you work through them?
the healing cycle christian group therapy hook hook 20101
The Healing Cycle: Christian Group Therapy (Hook & Hook, 2010)
  • Safety- Freedom from fear anxiety, and apprehension as group members open up
  • Knowing that each group member can share vulnerable info. and it will be safe within the group (confidentiality, lack of judgment, each doing own work, pass if you want, consistent attendance and commitment to the group)
  • Boundaries- clear expectations
the healing cycle christian group therapy hook hook 20102
The Healing Cycle: Christian Group Therapy (Hook & Hook, 2010)

Vulnerability- Self disclosure, listening, and validation

  • Sharing and risk taking for the benefit of the group
  • Accessing feelings in session so that group members together can carry each other’s burdens

Truth- What God says about the situation, hearing input for others

  • Key- speaking truth in an attitude of love rather than one which produces increased hurt and damages more

Ownership- responsibility for each one’s own part in healing process

  • Includes telling the whole story, reducing blame on others, and refocusing on personal solutions
christian clients preferences about prayer in counseling weld eriksen 2007
Christian Clients’ Preferences About Prayer In Counseling (Weld & Eriksen, 2007)
  • 82% wanted audile prayer in session
  • Most wanted the therapist to broach the subject of whether spirituality is important in counseling and what that includes
  • Religious conservatives expected prayer more often and regularly compared to others
  • Studies that prayer can increase a sense of emotional well being in those who advocate it
  • Is prayer appropriate?: Only 11% in secular agencies compared with 78% in Christian agencies and 100% in Christian private practices
christian clients preferences about prayer in counseling weld eriksen 20071
Christian Clients’ Preferences About Prayer In Counseling (Weld & Eriksen, 2007)
  • “If we don’t let clients know that we are willing to talk about their spiritual lives if thy feel it would be helpful to therapy, then what we don’t say is in effect telling them that it is not okay to talk about these things.”
prayer in clinical counseling weld eriksen 2007
Prayer in Clinical Counseling(Weld & Eriksen, 2007)

Prayer showed statistically significant results in areas of conflict resolution:

  • Softening
  • Developing a

healing perspective

  • Changing responsibility
narrative approaches to counseling pembroke 2005
Narrative Approaches to Counseling(Pembroke, 2005)
  • Reconceptualizing problem-bound stories
  • Helping the client re-assemble unique alternative outcomes
  • Helping the client make the new alternative endings and strong and as possible as the problem bound ones
  • Partnership in the story between the client, the counselor, and the support system (affirmation strength, strengthening)
family therapy walsh 2010 gostenick repic cvetek 2008
Family Therapy ( Walsh, 2010; Gostenick, Repic, & Cvetek, 2008)
  • 85% call self “religious”
  • 44% have changed backgrounds from upbringing
  • Over 60% are part of a congregation yet only 38% attend weekly
  • Very significant for African-Americans
  • Latinos often strongly involved in Catholicism although more turning to Pentecostal and Charismatic churches for direct spiritual experiences, emphasis on tradition with dead relatives
  • Latin Americans, Africans, and Asians- spirituality is significant to daily life
  • Potential Areas to Assess and Address (frequent systems concerns):
  • Interfaith marriage, child rearing, death and loss, rituals and traditions or practices, connectedness with nature, involvement with creative arts, involvement with social activism
  • Gaps between belief and practice- e.g Over 90% of American homes have a Bible but 58% of Americans cannot name the Ten Commandments and do not know who the 12 Apostles are
  • NOTE: Can use similar questions regarding above areas and self and meaning in life with atheists.
christian approach for mood disorders hankle 2010
Christian Approach For Mood Disorders (Hankle, 2010)
  • A narrative and journaling approach using the Psalms
  • A means to process emotions, including the unpleasant ones (anger, questions, doubt, depression, anxiety, etc.)
  • Giving voice to internal concerns

Format:

Feeling, questions, BUT pos. self message

Emotions spiritual resources, faith statement

slide49
Spiritual Approaches in Counseling that Highly Religious Clients Said Were Helpful (Martinez, Smith, & Barlow, 2007)
  • Reference to Scripture
  • Therapist keeping them in prayer privately
  • Religious/spiritual assessment
  • Religious/spiritual self disclosure
  • Religious/spiritual imagery
  • Religious/spiritual confrontation
  • Therapist/client prayer in session
  • Encouraging forgiveness
slide50
Spiritual Approaches in Counseling that Highly Religious Clients Said Were Helpful (Martinez, Smith, & Barlow, 2007)
  • Supporting client involvement in religious community
  • Client prayer at home
  • Religious bibliotherapy
  • Encouraging client confession
  • Spiritual journaling
slide51
Empirically Supported Religious and Spiritual Therapies (Hook, Worthington, Jr., Davis, Jennings, Gartner, Hook, 2010)
  • All previous approaches were outlined in clinical counseling literature and shown to be effective
  • All approaches shown to be as effective as clinical (secular) counseling but not all were consistently shown to be superior to clinical counseling
  • We are to only use treatments in clinical counseling which are shown effective in the literature
dealing with a client at a spiritual bypass cashwell myers shurts 2004
Dealing With A Client At A Spiritual Bypass (Cashwell, Myers, & Shurts, 2004)
  • Spiritual bypass- “the use of spiritual experiences to avoid or bypass psychological wounds or other unfinished business”
  • Spiritual versus natural polarization
  • Seeing spiritual as a higher realm and natural work as lesser
  • A defense mechanism to compensate for low self esteem, anxiety, narcissism, depression, or dependency
dealing with a client at a spiritual bypass cashwell myers shurts 20041
Dealing With A Client At A Spiritual Bypass (Cashwell, Myers, & Shurts, 2004)
  • Exs: spiritual person who is isolated spending all day reading spiritual writings to justify detachment
  • Teachings that justify never feeling or expressing any emotion (even in healthy ways)
  • Spiritual ego inflation to feel superior to those who “are not as enlightened”
  • Signing up for every ministry or outward involvement possible to keep busy but not have to receive ministry or help to self
  • Allowing others to treat you any way without boundaries or expectations because boundaries “would be unloving”
dealing with a client at a spiritual bypass cashwell myers shurts 20042
Dealing With A Client At A Spiritual Bypass (Cashwell, Myers, & Shurts, 2004)

DCT Therapy

  • Make sure all 4 domains are addressed:
  • Sensorimotor- body or felt sensations (what are you seeing or hearing now?)
  • Specific examples- describing a sequence of events related to those sensations (what happened? What was going on before” and “How did it end up?
  • Identifying patterns- helping client note how often senses, storylines, and their reactions to them are interconnected. Then helping give client work through option and formal operational thinking to problem solve potential alternatives
ethical issues in christian spirituality based counseling reinhert edwards hendrix 2009
Ethical Issues In Christian/Spirituality Based Counseling (Reinhert, Edwards, & Hendrix, 2009)
  • Counselors are not to give the impression of being religious authorities
  • Maintain focus on the well being (good) of the client
  • While clients may be interested in our values we are not to impose them.
  • We are not to focus spiritually to the absence of clinical counseling goals
  • We are not to misuse spiritual interventions, prayer as a way of avoiding important clinical issues
  • We should refer to appropriate spiritual resources in the community when appropriate
  • It is our obligation to seek education and training to develop ongoing competency in this area particularly if client populations we serve consider religion or spirituality to be crucial issues
ethical situations how much training was received schneller swenson iii sanders 2010
Ethical Situations- How Much Training Was Received? (Schneller, Swenson III, Sanders, 2010)
  • Discuss confidentiality at beginning of therapy-98.3%
  • Obtain informed consent-97.3%
  • Consult with peers/colleagues on dif.cases-97.5%
  • Being sexually attracted to a clinet-95.5%
  • Obtaining regular supervuison-95.3%
  • Consult with specialists in mental health field -95.1%
  • Providing therapy to a friend- 94.6%
  • Choosing to take clients that have problems beyond your scope of practice-94.3%
  • Referring clients to specialist in the mental health field-94.1%
  • Requesting favors from clients- 93.4%
  • Discussing things with clients without release- 93.3%
  • Using self disclosure when appropriate- 92.0%
  • Providing therapy to coworkers- 91.5%
  • Referring clients when they are not making progress- 90.5%
  • Administering psych tests you do not have training for- 90.4%
ethical situations how much training was received schneller swenson iii sanders 20101
Ethical Situations- How Much Training Was Received? (Schneller, Swenson III, Sanders, 2010)
  • Accepting client gifts worth more than $50- 89.6%
  • Disclosing info. to church leaders without signed release if clients- 89.2%
  • Accepting goods in lieu of a fee- 89.1%
  • Socializing with a client after terminating therapy- 87.9%
  • Providing therapy to someone with whom you had a previous social relationship- 87.3%
  • Discuss clients with friends, without using client names- 85.6%
  • Purchasing goods from clients- 85.1%
ethical situations how much training was received schneller swenson iii sanders 20102
Ethical Situations- How Much Training Was Received? (Schneller, Swenson III, Sanders, 2010)
  • Share with a client that you believe he is engaged in immoral behavior- 59.4%
  • Provide treatment to homosexual who is seeking to change their orientation- 59.3%
  • Share in general with a client that you believe certain behaviors are immoral- 58.7%
  • Use Scripture though not requested- 56.9%
  • Obtain prior informed consent from a client before using faith practices in session-54.8%
  • inform clients wishing to change homosexual orientation about risks of this- 53.6%
  • Provide therapy to a minster who refers clients to you- 53.5%
  • Attend church with a former lover or ex-spouse of an ongoing client- 52%
  • Rely more on the Bible than ethics- 49.1%
  • Talk with your employer and religious practices in therapy- 49.1%
  • Avoiding certain clients o you won’t be sued- 49.1%
  • Seeking support from a minster- 48.7%
  • Advertising yourself as a Christian counselor though you have no training in this- 47.7%
  • Confront or report a Christian therapist wh0 you believe is misusing faith practices-47.2%
  • Tell clients that you believe God answers prayer or heals- 46%
  • Hesitate to refer to someone without Christian values- 45.2%
  • Without quoting the Bible use stories from the Bible- 41.6%
  • Use exorcism in your sessions- 35.3%
perceptions of counselors versus average person client
Perceptions of Counselors VersusAverage Person/Client

Counselors/theoristsAvg. person/client

  • Cognitive commitment to Do the work of forgiveness

forgive initiates the treatment and then decide later about

and forgiveness process commitment to forgive

  • Commitment to forgive is an Commitment to forgive is

“easier” early stage the most important part of

the entire forgiveness process and also the most difficult.

  • Bearing the pain is necessary Have to act civil but don’t

and positive step in healing have to bear injustices if not client’s responsibility

  • Social support systems necessary Social supports necessary

during the deeper work phases of to even start and go through

forgiveness every phase of forgiveness

four types of reactions to offenses dr janis abrahms spring 2004 page10
Four Types of Reactions to OffensesDr. Janis Abrahms-Spring (2004) Page10

Hurt party deals Offender Participates Reconciliation

Cheap

Forgiveness no no no

Refusing to

Forgive no no no

Acceptance yes no yes or no

Genuine

Forgiveness yes yes yes

cheap forgiveness
Cheap Forgiveness
  • Individuals quickly do an action to behaviorally seem as if they have absolved someone but does nothing to foster genuine interpersonal healing and improved relational dynamics
  • Considered inauthentic, cover for hatred and contempt and other emotions not dealt with
  • Premature
  • No processing of emotions
  • Common among those who want to keep relationship at any cost:

(E.g. Overly compliant, conflict avoiders, codependent caretakers)

  • Can lead to moral superiority
  • May set hurt party up for health and emotional problems
refusing to forgive
Refusing To Forgive
  • When you think forgiveness is not possible without reconciliation
  • To send a clear signal that you won’t accept a violation
  • Control and punishment based
  • Fosters sense of impotence and invulnerability
  • Common in people with all or nothing polarized thinking
acceptance
Acceptance
  • Feels all the emotions and does not bypass the emotional work of the wounded party
  • Promotes healthy self care- overcome revenge, ensuring your safety, restoring self worth, resisting obsession
  • Especially when the offender is not an active part of healing process
  • When reconciliation is not healthy or possible
  • Able to empathize with the offender
  • Looks at both parties parts in things
genuine forgiveness
Genuine Forgiveness
  • “An intimate dance between offender and the offended”
  • Offender recognizes and verbalizes need to be forgiven
  • Each takes responsibility for his or her part
  • To assess the injury together and reprocess
  • Not just automatic but is work and is earned, conditional
  • Offender express genuine remorse and specific plan to avoid behavior in the future
  • Offender hears the depth of the pain caused and listens to the offended then works to make amends and get the relationship back on track
  • Allows for detailed discussion of all parts of the pain without debating or cutting off or correcting the other’s experience/perception
  • Involves behavioral requests and responses
ingredients of a good apology
Ingredients of a Good Apology
  • 1)With responsibility for each persons’ part in the offense.
  • 2) Personal: (When ___ happened you felt ____. You needed _____ and in the future you hope for _______).
  • 3) Specific behavior plan for the future- how we will handle triggers again.
  • 4) Deep apology, not just surface level.
  • 5) Genuineness in interactions
  • 6) Direct apology without a bunch of other stuff
examples of bad apologies
Examples of Bad Apologies

Avoid:

  • Sorry.
  • I am sorry for whatever hurt you.
  • What else do you want now?
  • I am just like this. This is how I am but I am sorry.
  • This is my personality, culture, etc. It is not likely to change.
  • I’ll say I’m sorry if it will help but I don’t know why.
  • I cannot believe you need me to apologize for that.
  • I am sorry for ___ BUT ….
cognitive models of forgiveness object transformation e g cioni p f 2007
Cognitive Models of Forgiveness &Object Transformation(e.g.- Cioni,P.F.-2007)
  • Unforgiveness/Woundedness (Revenge Based Cognitions)
  • Versus Forgiveness (Changing Cognitive Attributes and Perspectives)
object transformation
Object Transformation

Negative CognitionsForgiveness-Based Cognitions

Violation occurs Violation occurs

Negative emotions follow Negative emotions follow

“I will get even”,” I want revenge”, “I will choose to forgive this person.

“They will not get away w/this”, The violation no longer has control over me.”

”He/she must pay for this”.

I can’t stand this pain”,

“I cannot tolerate this,”

“I must get even.”

The object-image changes from Negative emotions are alleviated.

friend to enemy.

Aggressive energy is directed The object-image is less threatening or

toward the object which produces remains non-threatening. Freedom from inner innerconflict. conflict is enhanced, peace restored, and life renewed.

examples of object transformation
Examples of Object Transformation
  • Therapist recommends forgiveness and reframes as a healthy choice.
  • Therapist explains object formation as an inexact and incomplete representation of the person viewed through our own emotional lenses.
  • Therapist assists the client in learning how to identify toxic thoughts and change cognitions.
  • Therapist reminds client that forgiveness may have to be re-chosen each time the unpleasant emotions resurface.
narrative interventions for forgiveness landry d f rachal k c rachal w s rosenthal g t 2005
Narrative Interventions For Forgiveness(Landry,D.F., Rachal,K.C, Rachal,W.S., & Rosenthal,G.T.- 2005)
  • Translating thoughts into narrative makes emotional processing and forgiveness more manageable
  • Look at the frequency of words- increase the frequency of positive and neutral words (attribution retraining)
  • Helps a great deal with rumination aspects of both self forgiveness and other forgiveness
  • The longer the intervention the larger the effects
  • Gains maintained over time
  • Strengths- when therapist directed and with perspective taking can promote empathy
narrative interventions continued park c l bloomberg c j 2002
Narrative Interventions Continued(Park, C.L. & Bloomberg, C.J.- 2002)
  • 2 groups in study- writing about traumatic experiences including deepest thoughts and feelings vs. mundane things like what belongings are in your closet or describe your outfit today
  • Meaning making hypothesis was supported: facilitating someone’s cognitive processing of events through narrative means eventually gives rise to changes in situational meanings, global meaning or both, produces less distress
  • Simply identifying a traumatic event but not writing about it or focusing on some other mundane thing shows no significant changes
narrative interventions continued bootzin r 1997
Narrative Interventions ContinuedBootzin, R.- 1997
  • Narrative interventions produced similar effect sizes to those produced by aerobic exercise
  • Immune function and physiological stress reactions were less when people write about distressing events
  • Linguistic Word Count studies: Three Significant Factors:
    • The more positive words a client used to describe an event
    • The less extreme words (either very positive or very negative)
    • Increase in casual/neutral words or insight words
hope focused marriage enrichment ripley j s worthington e l jr 2002
Hope-focused Marriage Enrichment(Ripley,J.S. & Worthington,E.L., Jr.- 2002)
  • 1. Teach clients to promote at least a 5 to 1 positive to negative interaction ratio.
  • 2. Teach empathy- First person speaks followed by a valuing empathy statement of the second person before second person responds.
  • 3. LOVE- L=listen to your partner

O=observe your effects on your partner

V=value your partner

E=evaluate common interests

  • 4.Incorporate intimacy building exercises (e.g. Gestalt moving closer, solution focused interchanges and valuing statements)
  • 5. Coupes write a love letter to each other.
empathy centered forgiveness based intervention continued
Empathy-Centered Forgiveness-Based Intervention- Continued

Therapeutic Tasks:

  • Ask each person in the family or group or relationship to describe from his/her point of view and facilitate hearing and empathy by others
  • Follow up with assisting others to think based on the initial comments about what may please the first communicator (perspective taking)
  • Help the “group” speak to common feelings and perception
  • Facilitate each admitting his/her part and verbalizing commitment to ongoing healthy relationship
empathy centered forgiveness based intervention ripley j s worthington e l jr 2002
Empathy-Centered Forgiveness-Based Intervention(Ripley,J.S. & Worthington,E.L., Jr.- 2002)

Five parts:

  • 1. Empathizewith the offender to promote forgiveness.
  • 2. Humility (choice of the offended) as the offended recalls times when he/she has received forgiveness from the person who offended them.
  • 3. Shift from blame and resentment to willingness to forgive.
  • 4. Commitment aloud to forgive the offender.
  • 5. Maintenance- discussion of how the offender may prove him/herself on an ongoing basis.
developing an attitude of humility
Developing An Attitude of Humility

“ I see my offender’s motivations and understand

his or her point of view. I feel what he or she might

have been feeling. Further, I have felt similar

feelings. I see that I have done things or wanted to

do things as wicked as the other person. In those

instances of my own weakness, I would like to have

forgiveness extended to me. I want mercy for my

own foibles. Who am I to demand justice for this

person when I want mercy for myself? I know that

the other person is needy. I want to help this person.

I want to release him or her from the hate, anger, and

desire for retribution that I feel. That is the decent

thing to do. That is the right thing to do.”

attachment theory models of forgiveness lawler row k a younger j w piferi r l jones w h 2006
Attachment Theory Models of Forgiveness(Lawler-Row,K.A., Younger,J.W., Piferi,R.L, & Jones,W.H.- 2006)
  • Secure attachment styles associated with forgiveness.
  • Linked to degree to which people can:
    • Tolerate negative affect
    • Experience pain
    • Communicate feelings
    • Reframe the offender
    • Have better internal emotional regulation
    • Demonstrate broader emotional expressiveness
    • Have less idealized expectations and more flexibility in relationship interactions
  • Insecurely attached: avoidance, difficulty working through the relationship, physiological problems
slide79
Parenting Forgiveness Model (Kiefer, Worthington, Myers, Kliewer, Berry, Davis, Kilgour, Miller, Van Tongeren, & Hunter, 2010)

The FREE Program taught to parents of 0-9 year olds:

  • Helping better understand child development
  • Putting the child’s behaviors in context
  • Dealing with adult relational issues that may affect parenting
  • Stress management for parents
  • Teaching behavioral parenting strategies
  • Ultimately: replacing negative emotions of anger, bitterness, hostility, and fear with empathy, sympathy, compassion and parental love
positive psychology for dealing with harm and unforgiveness bono mccullough 2006
Positive Psychology For Dealing With Harm and Unforgiveness (Bono & McCullough, 2006)
  • Positive psychology- not what happens as much as a person’s reaction to it
  • Forgiveness and gratitude leads to increased optimism and well being
  • Empathy for the transgressor
  • Recognition of one’s own flaws and shortcomings
  • Generous attributions and appraisals for the transgressor’s behavior
  • Reduced rumination
positive psychology for dealing with harm and unforgiveness bono mccullough 20061
Positive Psychology For Dealing With Harm and Unforgiveness (Bono & McCullough, 2006)
  • Gratitude
    • A cognitive-affective state
    • Not earned or deserved
    • Drives us to respond in kindness
    • Inhibits destructive responses
    • Intentionally given
    • Produces greater satisfaction in life
  • Imagining forgiveness:
    • Higher levels of gratitude, hope, and empathy
    • (Bassett, Bassett, Lloyd, & Johnson, 2006)
slide82

Dispositional Forgiveness (Sandage & Williamson, 2010; Bellah, Blellah, & Johnson, 2003; Van OyenWitvl;iet, Ludwig, & Vander Laan, 2001 )

  • More differentiated= more forgiving, less prone to polarizing situations and instability problems due to lack of emotional regulation, more secure attachments, gratefulness, empathy, loving God and others, flexibility to new ways of telling the story
  • Unforgiveness= grudges, negative imagery, greater muscle tension, arousal, high blood pressure, rehearsing memories of hurt, vengeance
decisional vs emotional forgiveness w orthington van oyen witvliet pietrini miller 2007
Decisional Vs. Emotional Forgiveness (Worthington, Van OyenWitvliet, Pietrini, & Miller, 2007)
  • Decisional forgiveness- behavioral intention to resist unforgiveness
  • Emotional forgiveness- replacement of negative emotions with positive, other-oriented ones
  • Which does the literature show is generally more effective?
group forgiveness intervention harris luskin norman standard bruning evans thorsen 2006
Group Forgiveness Intervention (Harris, Luskin, Norman, Standard, Bruning, Evans, & Thorsen, 2006)
  • R- Recalling the event
  • E- Empathy
  • A- giving and altruistic gift of forgiveness
  • C- Publically committing to the forgiveness
  • H- holding onto gains received
empathic dialectical reframing model continued
Empathic Dialectical Reframing Model Continued

Rapport

  • Counselor’s responsibilities are strong here- counselor as psychoeducational teacher
  • Counselor to teach idea of “empathy as dialectic imagination”- talk to client about learning a way of moving away from self perception being applied onto other (transgressor) toward reaching outward toward other instead
  • Counselor to teach empathy and perspective taking skills and move client away from chronic self focus inward
empathic dialectical reframing model continued1
Empathic Dialectical Reframing Model Continued

Reframing

  • Assist one of the parties in making a statement to break the cycle of unforgiveness and selfish (e.g. “I know we have recently not been understanding each other very well but I would like for us to try and hear each other better so we can have a more peaceful home.”)
  • Reframing in terms of a cooperative problem solving solution-focused team venture.
empathic dialectical reframing model continued2
Empathic Dialectical Reframing Model Continued

Release

  • NOTE: Berecz talks of “release” instead of “reconciliation”
  • Belief that in some cases it may be “psychologically harmful” to try and reconcile (repeated infidelity of a spouse, abuse, addiction)
  • Allows for disjunctive forgiveness whereby the offended can “accept” the understanding of the personhood, context, and personality issues of the transgressor but the offended can move on without letting them have a hold on the hurt party.
  • Releasing bitterness even if there will never be reconciliation or if the offender never repents or apologizes.
  • Helpful when the transgressor refuses to change his or her ways and sees nothing wrong even when you know what the offender did was wrong.
contextual therapy murray r j 2002 based on hargrave t d 1994
Contextual Therapy(Murray,R.J.-2002, based on Hargrave, T.D.-1994)
  • Four Stations
  • Station 1 &2 = Exoneration (attempts at removing culpability and ending condemnation toward the wrongdoer)
  • 1) Insight
    • Understanding of possible casual factors
    • Minimizes future damage in relationship
    • Looks at objective facts
  • 2) Understanding
    • The wrongdoers limitations, development, efforts, and possible intents
    • Placing things in larger context
    • Looks at subjective experiences and motivational factors
contextual therapy continued
Contextual Therapy Continued
  • Station 3 & 4= Forgiveness (actions regarding responsibility, wrongdoer admitting his/her part and trust being re-established)
  • 3) Opportunity for Compensation
    • Re-entering the relationship in a new way
    • Victim must agree to have the pain addressed by the perpetrator and allow self to be healed
    • Victim must decide if he/she is willing to trust the perpetrator and to what degree in the future
    • Addressing interactional systems patterns
contextual therapy continued1
Contextual Therapy Continued
  • 4) Overt Forgiving
  • Relational ethics applied- what entitled to receive versus what obligated to give
  • Defining what the relationship will look like from here
intentional forgiving ferch s r summer1998
Intentional Forgiving(Ferch, S.R.- Summer1998)
  • Largely cognitive based
  • Primary burden placed on the counselor as facilitator and educator
  • Forgiveness seen as an act of the will by the client and a deliberate decision to work through emotions and have mutual respect for the other person
  • Does not necessarily have to involve the offender but seen as more successful if it does involve the offender
  • Two phases:
  • 1) Psyhoeducation
  • 2) Face to face processing of forgiveness
intentional forgiving ferch s r summer19981
Intentional Forgiving(Ferch, S.R.- Summer1998)
  • Phase One: Psychoeducation
  • Considered the preliminary work
  • Counselor responsible for setting the client up and assisting him/her in understanding the work of forgiveness
  • Forgiveness framed as a choice
  • Reconciliation seen as possible and intentional when it wound be healthy
intentional forgiving ferch s r summer19982
Intentional Forgiving(Ferch, S.R.- Summer1998)

Steps of Phase One:

  • 1) Teach client that forgiveness is a choice.
  • 2) Frame as a process.
  • 3) Assist the client in receiving the offense. Forgive because you will remember the offense. Allow and facilitate grief and mourning.
  • 4) Forgive for yourself, not the offender.
  • 5) Help the client conceptualize forgiveness in light of both mercy and justice.
  • 6) Help client understanding and differentiate between the intent of a person and his/her actions and to consider possible positive intent.
  • 7) Help the client permit the re-evaluation and modification of relationship when necessary.
intentional forgiving ferch s r summer19983
Intentional Forgiving(Ferch, S.R.- Summer1998)

Steps of Phase Two:

  • 1) can be phone call or letter or in person
  • 2) not for use with possible re-offenders
  • 3) not for use if offender does not seem to buy into tenants of intentional forgiveness
  • 4) use body language and positioning- facing each other, open posture, welcoming facial expressions, and calm open tones of voice
  • 5) assist the client in naming the offender’s behavior while assisting the offender in listening (do not allow for excuses)
  • 6) be directive toward the client’s engaging the offender’s care, concern, and loving expression toward the client
  • 7) help the offender ask forgiveness directly
  • 8) help the client respond specifically by offering forgiveness
  • 9) teach less defensive ways of communication between the two parties (e.g. I statements)
  • 10) use therapeutic touch and positioning between the parties when appropriate to affirm closeness again and openness to redeveloping sense of “us”
enright fitzgibbons studies process model
Enright & Fitzgibbons Studies: Process Model
  • Four stages of forgiveness:
    • 1) Uncovering
    • 2) Decision
    • 3) Work
    • 4) Outcome
  • Uncovering- explore past grievances and areas that need forgiveness, regrets, and disappointments
  • Decisions- Examine the consequences of holding on to past hurts versus letting them go
  • Work stage- Helping process with the client the thoughts, feelings, and images regarding forgiveness of the key issue(s)
  • Outcome- Create a ritual between the client and other for providing closure to this process and plan for dealing with things from here
enright fitzgibbons studies process model1
Enright & Fitzgibbons Studies: Process Model

Uncovering Phase (Steps 1-8)

  • 1. Examination of psychological elements
  • 2. Confrontation of anger; the point is to release, not harbor the

anger

  • 3. Admittance of shame, when it is appropriate
  • 4. Awareness of catharsis
  • 5. Awareness of cognitive rehearsal of the offense
  • 6. Insight that the injured party may be comparing themselves with the

injurer

  • 7. Realization that one may be permanently and adversely changed by

the injury

  • 8. Insight into a possibly altered “just world” view
enright fitzgibbons studies process model2
Enright & Fitzgibbons Studies: Process Model

Decision Phase (Steps 9-11)

  • 9. A change of heart/conversion. New insights that old resolution strategies are not working
  • 10. Willingness to consider forgiveness as an option
  • 11.Committmnet to forgive the offender
enright fitzgibbons studies process model3
Enright & Fitzgibbons Studies: Process Model

Work Phase (Steps 12-15)

  • 12. Reframing, through role taking, of who the wrongdoer is by viewing him or her in context
  • 13. Empathy and compassion towards the offender
  • 14. Acceptance/absorption of the pain
  • 15. Giving a moral gift to the offender
enright fitzgibbons studies process model4
Enright & Fitzgibbons Studies: Process Model

Deepening Phase (Steps 16-20)

  • 16. Finding meaning for oneself and others in the suffering and in the forgiveness process
  • 17. Realization that one has needed others’ forgiveness in the past
  • 18. Insight that one is not alone (universality, support)
  • 19. Realization that one may have a new perspective in life because of the injury
  • 20. Awareness of decreased negative affect and, perhaps, increased positive affect, if this begins to emerge, toward the injurer; awareness of internal, emotional release
factors in relational forgiveness kelley waldron 2005
Factors in Relational Forgiveness (Kelley & Waldron, 2005)
  • Explicit knowledge- apology and expressions of remorse
  • Nonverbal assurance- actions aimed at showing the event is not likely to re-occur
  • Explanation- give full details, motives, and reasons
  • Compensation- persistent willingness to comply with the partner’s wishes to do what the offended wanted
coping strategies for interpersonal hurt strelan wojtysiak 2009
Coping Strategies For Interpersonal Hurt (Strelan & Wojtysiak, 2009)
  • Coping- thoughts and behaviors individuals use to manage internal and external demands of particular situations they appraise as being personally relevant and stressful
  • Early on use avoidance and in middle and later stages of recovery use approach
  • Avoidance- regulation of one’s cognitions and emotions
  • Approach-problem solving
  • When this pattern emerged people were better able to assign constructive meaning in spite of the hurt
forgiveness factors in children worthington jennings ii diblasio 2010
Forgiveness Factors in Children (Worthington, Jennings II, & DiBlasio, 2010)
  • Developmental stage
  • Attachment
  • Emotional regulation
  • Coaching from their parents
  • How they appraise situations
  • The religious/spiritual environment at home
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