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A description of the experiences of the presence of spirituality in counselling by therapists who identify… Chalmers, Lynda 2001

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A DESCRIPTION OF THE EXPERIENCES OF THE PRESENCE OF SPIRITUALITY IN COUNSELLING BY THERAPISTS WHO IDENITIFY THEMSELVES AS CHRISTIANS by LYNDA CHALMERS B.A., The University of British Columbia, 1993 A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS In THE FACULTY OF GRADUATE STUDIES Department of Educational and Counselling Psychology, and Special Education We accept this thesis as conforming to the required standard University of British Columbia August 2001 © Lynda Helena Chalmers, 2001 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. 1 further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. The University of British Columbia Vancouver, Canada Department of DE-6 (2/88) 11 ABSTRACT This qualitative study explored the lived experience of the presence of spirituality in counselling among qualified therapists who identified themselves as practicing Christians. Opportunity was given to six men and three women representing six Christian denominations to provide the meaning and in depth expression of their experience of the presence of spirituality in counselling. Participants were experienced therapists with a Masters level or PHD degrees in counselling. The methods of inquiry and data analysis were based on an existential phenomenological approach. The researcher conducted and transcribed an interview with each participant. The significant statements from each interview were transformed into meaning units. These meaning units were clustered into themes for each participant. A follow-up interview with each contributor validated their individual descriptions and themes. Twenty-three themes emerged from the data and a common story was compiled from the exhaustive description of the phenomena. The themes were organized under the titles as follows: Integrating Themes of Psychology and Spirituality in the Presence of Spirituality in Counselling; (1) The Integration of Spirituality in the Training Process, (2) The Integration of Spirituality in the Practice of Counselling; Facilitating Themes of the Presence of Spirituality in Counselling; (3) Therapist's Predisposing Framework, (4) Client's Predisposing Framework, (5) Therapist's Spiritual Journey, (6) Therapist's Sense of Calling, (7) Spiritual Themes, (8) Spiritual Processes; Revealing Themes of the Presence of Spirituality in Counselling; (9) Mystery and Difference, (10) Connection, (11) Depth of Meaning, (12) Intensity of Emotional Experience (13) Focussed Intensity, (14) Sense of Finiteness, (15) Dependence on God, (16) Sense of Self Transcendence (17) Felt Transcendent Presence / Intervention (18) Enlivenment, (19) Hope, (20) Relinquishment and Transformation and Reflective Themes of the Presence of Spirituality in Counselling; (21) Participation in a Greater Purpose, (22) Personal Significance, (23) Professional Highlight. The findings of the study added to and extended the experiential research basis for previous conjecture regarding the presence of spirituality in counselling. The findings were interpreted in light of a literature review. The findings from the study led to implications and recommendations for further research and counselling practice. iv TABLE OF CONTENTS ABSTRACT ii TABLE OF CONTENTS iv LIST OF FIGURES vii ACKNOWLEDGEMENTS viii CHAPTER I: INTRODUCTION AND RATIONALE 1 Introduction 1 Purpose of the Study 7 Definitions 13 Definitions of Spirituality 13 Definitions of Religion 17 Definition of a Practicing Christian 20 Rationale for Methodology 21 CHAPTER II: REVIEW OF THE LITERATURE 22 Introduction 22 Historical Theorists and Spirituality 22 Modern Theorists and Spirituality 26 Counselling and Spirituality 28 Models of Integration of Spirituality and Counselling 30 Research Studies Showing the Effects of Religious/Spiritual Beliefs 31 Spiritual Assessment within Counselling 37 Development and Spirituality within Counselling 39 Counselling Processes and Spirituality 42 Conclusions 45 CHAPTER III: METHODOLOGY 46 Introduction.... 46 Research Design 48 Procedure 49 Framing the Question 50 Bracketing 50 Selection of co-researchers 51 Data collection 52 Researcher ; 53 Interviews 53 Data analysis 54 Ethical Considerations 57 Reliability and Validity 57 Reliability 57 Validity 58 Trustworthiness 58 Investigator Triangulation 60 CHAPTER TV: RESULTS 62 The Participants .62 The Themes 64 Clusters of Themes 65 The Exhaustive Description of Themes 67 Integrating Themes of Psychology and Spirituality in the Presence of Spirituality in Counselling 67 1. The Integration of Spirituality in the Training Process 67 2. The Integration of Spirituality in the Counselling Process 71 Facilitating Themes of the Presence of Spirituality in Counselling 75 3. Therapist's Predisposing Framework 76 4. Client's Predisposing Framework 81 5. Therapist's Personal Spiritual Journey 85 6. Therapist's Sense of Calling 90 7. Spiritual Themes 91 8. Spiritual Processes 94 Revealing Themes of the Presence of Spirituality in Counselling 96 9. Mystery and Difference 96 10. Connection 98 11. Depth of Meaning 100 12. Intensity of Emotional Experience 102 13. Focussed Intensity 104 14. Sense of Finiteness 106 15. Dependence on God 107 16. Sense of Self Transcendence 108 17. Felt Transcendent Presence/ Intervention 110 18. Sense of Enlivenment 113 19. Hope 115 20. Relinquishment and Transformation 116 Reflective Themes of the Presence of Spirituality in Counselling 118 21. Personal Participation in a Greater Purpose 119 22. Personal Significance 120 23. Professional Highlights 122 The Common Story 123 CHAPTER V: DISCUSSION 126 Summary of Purpose and Results 126 The Relation of Research Results to Literature 127 Identified Themes 127 The Integration of Spirituality and Psychology in the Presence of Spirituality in Counselling 128 Facilitating Themes in the Presence of Spirituality in Counselling 128 Revealing Themes in the Presence of Spirituality in Counselling 131 Reflective Themes of the Presence of Spirituality in Counselling 133 Definitions 133 Therapist's Sense of Personal Spirituality 139 Therapist / Client Relationship 141 Integration in Training and Practice 141 Spiritual Assessment 147 Mystical Experience • 148 Transformation 149 Development and Spirituality within Counselling 150 vi Specific Counselling Processes and Spirituality . 151 The Recursive Nature of the Presence of Spirituality in Counselling 153 Limitations of the Study : 154 Research Implications and Recommendations 155 Implications for Practice 158 Conclusions 159 REFERENCES 161 APPENDIX A: BRACKETING 171 APPENDIX B: LETTER DESCRIBING STUDY FOR PROSPECTIVE PARTICIPANTS ... 176 APPENDIX C: CONSENT FORM 178 APPENDLX D: INTERVIEW QUESTIONS 180 APPENDIX E: PARTICIPANTS FOLLOW-UP INTERVIEW QUESTIONS 181 APPENDTX F: INVESTIGATOR TRIANGULATION QUESTIONS 182 vii LIST OF FIGURES FIGURE 1: Three Domains of Language and Meaning in Therapy 135 FIGURE 2: Schematic Representation of Human Dimensions 137 Vll l ACKNOWLEDGEMENTS I would like to express my gratitude to my principle supervisor, Dr. Bill Borgen, for his continued guidance and support throughout my academic growth and most particularly throughout this study. I appreciated his ongoing encouragement, belief in me, availability and inspiration for the research. I would like to acknowledge the time and good will on the part of the participants in this study. I appreciated their willingness to share their stories and felt privileged to be a part of their meaning making process. They have enriched my life. My appreciation is extended to my family and friends who encouraged me, heard my defeats and victories, gave me hope and gladly sacrificed for me. Your gifts of love made this effort possible. Finally, I give thanks to God for the miracle of people and the opportunities I have had through this study. 1 CHAPTER I INTRODUCTION AND RATIONALE Introduction Spirituality is increasingly being considered in the field of counselling. This stands in opposition to psychology's mechanistic roots that made reductionistic thinking the norm. Psychology's quest to be recognized as a scientific discipline made the exclusion of spirituality a necessity, in an attempt to explain and control change, and to create a rigorous discipline where rational thought was the dominant influence. This made the area of spirituality difficult to bring forward in psychology in Western cultures and hampered the effectiveness of therapists' involvement in an important element of being human. As the field of psychotherapy emerged, there was a clear separation: theology focussed on the spiritual, while emotional problems were the province of psychology. The legacy of Freud's scorn for religion as a crutch helped to create a belief system based on faith as incompatible with psychology (Benner, 1988; Genia, 1995). The emergence of behaviourists such as Watson (1913, found in Kalat, 1986), who objected to introspection and held that psychology as a science must concentrate on measurable and observable behaviour, furthered the distance of spirituality from the framework of psychology. Behaviour therapy tended to ignore spirituality or religion as a variable. Other major influencers, such as Ellis (1980), who was the originator of cognitive therapy, claimed that "the less religious [clients] are, the more emotionally healthy they will tend to be" (Ellis, 1980, p.637). Even areas of humanistic-existential psychology that share issues central to spirituality and religious beliefs such as mortality, freedom, responsibility, isolation, intimacy and ontological meaninglessness, often see 2 transcendence as a higher level of consciousness and may still be as unsympathetic towards religiously affiliated supernatural power beliefs (Genia, 1995). Many therapists continue to ignore or mistrust religion and spirituality and preserve the legacy of Freud, viewing faith as unscientific and pathological, or at best, a comforting illusion, a projection or a sublimated form of narcissism (Benner, 1991; Butler, 1990; Groeschel, 1987; Prest& Keller, 1993). These circumstances have resulted in a general population in which 90% of Canadian people have beliefs around God and practices related to spirituality (Bibby, 1993) and a professional population which has little theory to draw on about the spiritual self to help them in their process of therapy. Additionally, a professional stance drawn from a legacy of the scientific paradigm that has viewed religion or spirituality as part of psychological dysfunction, makes it difficult, if not impossible for clients and therapists alike to consider making the issue of spirituality present in counselling. As Bergin and Payne (1991) have reported in their article on a proposed agenda for a spiritual strategy in personality and psychotherapy that it is paradoxical that traditional psychology and psychotherapy, which foster individualism, free expression, and tolerance of dissent, would be so reluctant to address one of the most fundamental concerns of humankind - morality and spirituality... We speak of wholeness but insist on parts; we value openness but stay partly closed; we like to be accepting but only of some things; it is good to be tolerant but not of things we don't understand. In the larger matrix of sociocultural variables, religion cannot be avoided as subject or object, cause or effect, noumena or phenomena (p. 201). By having a stance that ignores the spiritual frame of reference, a critical domain of 3 human experience is neglected. As with other domains, psychology's ignorance of spiritual constructs and experiences, predisposes therapists to misjudge, misinterpret, misunderstand, mismanage and neglect important segments of a client's life, which may impact significantly on the adjustment and growth of those clients we serve (Benner, 1988; Griffith & Griffith, 1995; Richards & Bergin, 1997). Changes in the portrait of spirituality in psychology are occurring, however. Our culture, including academia, is experiencing an upsurge of interest in spirituality. Perhaps the effects of a Western society where the largest segment of the population, the baby boomers, are reaching a developmental stage that seeks a new level of meaningfulness, purpose and an interdependent connection with self, others and the transcendent, is facilitating the changes (Walsh, 1999). Perhaps a shrinking globe, where eastern philosophies that have long incorporated spirituality as an important part of being human, may also be having an impact upon the resurgence in Western spirituality. Perhaps it is the growing sense of social isolation, brought on by longer working hours, combined with a lack of community with distanced family and a growing inability to cope with ever-increasing technology. Whatever the reasons, there is a turning towards spirituality. Changes in the paradigm of modernism to postmodernism within society are also pushing psychology from its deep rootedness in the scientific paradigm. Oden (1995) has synthesized some major descriptors of objective modernism that eliminated the area of personal experience and spirituality. He suggests the major factors are autonomy, individualism, demystification, secularization, naturalistic reductionism, scientific empiricism and historical criticism. The postmodern paradigm descriptors set out by Ingram (Ingram, 1993, found in Ingram, 1997) show the move towards a more subjective climate with room for spirituality. They include community, interpersonal orientation, emphasis on language, representational systems, local, smaller scale models and paradigms. These stand opposed to the former search for universals, a broader base of acceptable data sources, an emphasis on plurality of voices, especially those formerly seen as disenfranchized and an interest in the paradoxical, subversive and irrational as central concepts. Postmodernism and the accompanying increase in comfort with paradoxes and events not fitting into linear logical patterns of analysis, has also brought about the possibility of addressing spirituality in the field of psychology (Blakeney & Blakeney, 1992; Ingram, 1997). Unlike the field of psychology, some research areas have been responding to changing paradigms and have been attempting to integrate spirituality into their frameworks for some time. The field of health may have led the changes by responding with research which recognizes the positive connection between spirituality, religion or faith and positive medical outcomes (Koenig, 1997). The discipline of theology is also being forced to reconsider its stance of a separation of theology and psychology and one of its ongoing research topics is the integration of theology and psychology (Brokaw, 1997; Cole, 1998; Jones, Ripley, Kurusus & Worthington, 1998). Those within the field of psychology who are interested in spirituality within therapy, are finding that spirituality is not just a special topic in psychology which clients sometimes present as an issue. The area of spirituality is much more. It "involves streams of experience that flow throughout our lives, from family heritage to personal belief systems, rituals and practices and congregational affiliations" (Walsh, 1999, p.3). Theoretical writings suggest that spirituality has an impact upon peoples' lives in a variety of ways that may be conscious or concealed. Spirituality gives meaning to peoples' life experience, influencing their ways of thinking, their communicating and their attitudes toward human problems, symptoms and solutions. It also influences the type of treatment people see as appropriate, and the particular facilitators that are satisfactory, to enhance the acceptance or change that is needed (Benner, 1998; Shafranske, 1996; Walsh, 1999). Recently, the emergence of spirituality as a more acceptable topic of interest in psychology has been evident in a number of ways. Journals such as The Journal of Marital and Family Therapy (April, 2000), have entirely devoted themselves to the topic. Numerous books around the issue of spirituality have been published, including Spiritual Resources in Family Therapy (Walsh, 1999). Other books have been published by the American Psychological Association such as; A Spiritual Strategy for Counselling and Psychotherapy (Shafranske, 1997), Religion and the Clinical Practice of Psychology. (Richards & Bergin, 1997) and the Handbook of Psychotherapy and Religious Diversity (Richards & Bergin, 2000a). Additionally, the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV, 1994), the primary diagnostic source for mental health professionals, now leaves room for addressing spiritual issues as a focus of clinical attention. The V code 62.89, entitled, Religious or Spiritual Problem, gives possible examples such as distressing experiences involving loss or questioning of faith or spiritual values (not necessarily related to an organized church or religious institution), or problems involving conversion to a new faith (American Psychiatric Association, 1994, 9.685). Furthermore, the American Psychological Association (1992, p. 1601) mandates that psychologists become informed of religion as a dimension of human diversity and that this be addressed within clinical practice. Further to the perspective changes that have occurred towards the inclusion of 6 spirituality in psychology, are the ways in which information gathering is being carried out. Previously, quantitative research was the acceptable mode of research. Phenomena such as spirituality, the spiritual self and spiritual experiences have been difficult for researchers to form into adequate operational constructs and for individuals to describe. However, the 'knowing' that spirituality exists and has an impact psychologically is embedded in all cultures, as evident through a variety of symbols and experiential history. A growing acceptance of qualitative research as a viable form of research has made it possible for the field of psychology to expand its areas of research into human experience. This allowed the present study of spirituality to be carried out (Richards & Bergin, 1997). In many ways, the framework of a biological-psychological model in the field of psychology has been evolving towards a state where the issue of spirituality might be more acceptable for study and use in therapy. Instead of being tied to a medical-psychological model, the field has become more interested in a holistic stance. Psychology now looks to a bio-psycho-social model. A variety of theories, including feminist theory, have forced psychology to look at context in a larger way. Coming to own the spiritual parts of therapy which promote themes of wholeness, interconnectedness and transformation as spiritual in nature, is more viable within this kind of framework. Perhaps the field of psychology will progress towards a bio-psycho-social-spiritual model in therapy. Psychology is experiencing an apparent identity crisis (Benner, 1991). The field often views its origins from the advent of psychoanalysis at the turn of the nineteenth century. However, far before this time, philosophers such as Socrates saw themselves as 'healers of the soul'. Perhaps we are beginning to value our historical roots and realize 7 that, although therapy is viewed as a psychological process dealing with psychological disorders, it cannot be divorced from the deepest needs of our being, that of our soul. Counselling needs to take this opportunity to begin to develop a further understanding of spirituality and to develop language, theories and interventions in order to respond to what is apparently a large part of being human. As Shafranske (1996) has suggested, in the same way that therapists have been responsible in developing skills and sensitivity to issues such as race, gender, sexual orientation, culture and class, there is an ethical duty to develop expertise in addressing religious and spiritual concerns with clients. Interest in spirituality to date has been mostly descriptive or related to specific religious interventions (Worthington, Kunusa, McCullough. & Sandage (1996). To respond to the demand for attention to spiritual issues in therapy and the need for specific research in clinical practice, the research question was asked of therapists who are practicing Christians, "What is your experience of having spirituality present in your counselling?" This qualitative research questioned therapists who, by identifying themselves as Christians, value faith and believe in its potential to enrich and change peoples's lives about how they have been experiencing the presence of spirituality in their clinical practice. This research will contribute to the knowledge base necessary to further the competency of clinicians in the area of spirituality and practice. Purpose of the Study The purpose of this study was to gather reports from therapists who identify themselves as Christians with the aim of developing thematic descriptions of how these therapists experience the presence of spirituality in their counselling sessions. Exploring how Christian therapists experience spirituality in their counselling sessions will provide 8 an opportunity to advance understanding on a number of issues. Most significant is spirituality's importance as a dimension of being human. Lukoff, Lu & Turner (1992) suggest that "the spiritual and religious dimensions of culture are among the most important factors influencing human experience, beliefs, values, behavior, and illness patterns" (p. 673). Without ignoring what psychology already knows about the potential of pathology in the area of spirituality, psychology also needs to become more aware of the potential growth benefits of focussing on spirituality. People continue to be interested in spirituality. Kagan (1998, p.63) predicts that the trend towards spirituality will continue and in the future the average person's interest will move away from science and toward the spiritual side of human nature. According to several authors, there is a yearning or spiritual hunger that is felt by many (Anderson & Worthen, 1997). In his study of Canadians, Bibby ( 1993) found that although Canadians do not attend formal church services at the high rate that Americans do, 90% of Canadians believe in the existence of God and that He is important to them or becoming more important and many are interested in a variety of spiritual mysteries in life (p. 129). Taken from a phenomenological perspective, the present research affirms and respects the validity of these human experiences. Research on spiritual / religious variables and their impact on physical and mental health pointed to a motive for the study of having spirituality present in counselling sessions. Although the numerous ways both mental health and religion have been measured have produced discrepancies, the majority of research found that religion was associated in a positive way to both physical and mental health. Positive relationships have been found in physical health, longevity, suicide, drug use, alcohol abuse, 9 delinquincy and divorce (Gartner, 1996). Richards and Bergin (2000a) reported their summary of empirical findings on religion and mental and physical health in the last two decades. They found that those who are religiously and spiritually devout (although not extremists) enjoy better physical health and psychological adjustment and lower rates of pathological social conduct than those who are not (Payne, Bergin, Bielema & Jenkins, 1991; Richards & Bergin, 1997). Evidence also exists that religious and spiritual beliefs, practices and influences, can prevent problems and facilitate healing where problems have already occurred (Richards & Bergin, 2000b). Family process research has found that spiritual beliefs and practices are significant to healthy family functioning. Shared beliefs, values and practices involving the transcendent, strengthen families during the inevitable losses which living brings (Beavers & Hampson, 1990; Stinnet & DeFrain, 1985). Gallup Surveys (American respondents, 1996) showed that nearly 75% of respondents reported that their family relationships have been strengthened by religion in the home. They found that moral and spiritual values based on the Bible far outranked family counselling, parent training classes and government laws and policies as the main factor to strengthen the family, superceded only by family ties, loyalty and traditions. The current research furthers understanding of how therapists experienced the important variable of spirituality in the counselling sessions of clients. Many practicing therapists have been trained in the climate described above where the practice of Christianity, in fact any area of spirituality, was rejected and only explored with a pathological orientation. This has left many practitioners ill equipped as to how to make the area present in their therapy today. Many therapists find themselves conflicted between their professional practice and their spiritual beliefs and practices 10 (Beck, 1991). In an article which attempts to give an assessment of the spiritual dimension in counselling, Thomas Hart (1989) suggests that therapists who have been grounded in a Christian vision of life even before they were trained as therapists, find that although they may be fully operational in their work at some level, the art of integrating the two perspectives eludes them. In my own conversations with therapists from a Christian tradition, they report being more likely to suggest clients use eastern religious practices such as Kundaalini Yoga or Buddhist mindfulness meditation than suggest clients attend a Christian prayer meeting, even when research regarding the positive effects of prayer on mental health has been well documented (Dossey, 1993). Therapists seem to have a discomfort in the area of dealing with religion or spirituality that may come from their own assumptions and experiences which shape their approach to working with clients' spiritual concerns (Frame, 1996). Grimm (1994) suggests that therapists may experience the area of spirituality as more conflicted than their clients because of the disharmony between spirituality and the ideologies of psychology. This research provided insights on how therapists with a Christian faith tradition see the area of spirituality in therapy. In describing their meaningful experiences, therapists themselves can begin to increase their own understanding of a difficult topic to describe and may extend the level of the integration of their experience and their role as a therapist. In turn, this experience will help other therapists to begin to integrate spirituality into the practice of therapy. Individual therapists could be encouraged to find an increasing personal integration between the meaning of their faith and their counselling. It is generally agreed that the person of the therapist is an important part of the relationship that forms the therapy. A congruency in themselves and their work is a model to be striving towards. 11 A recent survey of clinical psychologists describes respondents as saying they have little or no training in the joint study of psychology and religion (Kelly, 1994; Shefranske, 1990; Shafranske & Maloney,1996). The growing interest in spirituality, and the reluctance of the field to deal with the issue of spirituality, has left counsellors bereft of professional expertise. As a result, they have difficulty responding to clients who report that they feel fragmented by having to discuss spiritual issues with the priests/pastors and relational issues with their therapists (Griffith & Griffith, 1992). Those who teach theology have little knowledge of the field of counselling and "those who teach counselling care little for theology, and never advert to it" (Hart, 1989, p.l 11). Therefore, students are left to their own devices in the area of spirituality and clinical practice. Pate and Bondi (1992) suggest that due to the lack of training in the area of spirituality, counsellors first need to learn to become sufficiently in touch with their own views of spirituality. They need to understand the impact of those views in order to explore these issues comfortably with their clients. Richards and Bergin (2000b) add their voices to the call of competence and suggest that therapists need to seek competency for a number of reasons. First, spiritual diversity is a cultural fact which therapists will encounter if they are open to hearing it. Second, clients will accept therapists as more trustworthy, and as having more credibility, if they are able to address their spirituality issues. Research indicates that devoutly religious people prefer to work with a religiously sensitive therapist for fear that other therapists mivjht try to undermine their faith (Worthington, McCullough & Saunders, 1996). Richards and Bergin (2000b) direct therapists to take responsibility for acquiring training to build trust and sensitivity to meet the needs of spiritually diverse clients. Third, training in religious diversity may help therapists to understand and access clients' 12 religious communities for the purpose of further support and healing. Lastly, Richards and Bergin (2000b) reiterate the ethical obligation to become trained in religious and spiritual diversity as part of multicultural counselling. They note the weakness of current multicultural writers that do not inform regarding the nature, worldview and values of spiritual and religious beliefs (Richards and Bergin, 2000b). This study aimed to stimulate therapists to their own spirituality and the impact it has on their clinical practice and to provide new knowledge regarding spirituality. Additionally, this research has provided a basis for expanding existing and future theory on spirituality and therapy. As noted by several authors, Worthington, Kunusa, McCullough. & Sandage (1996), and Richards & Bergin (1997), there is an improvement in recent years in both the quality and quantity of religious research and how it effects people in a general way, however, there is a lack of focus on its role in the therapeutic process. A great deal of descriptive theoretical writings in the area of spirituality as an overarching variable appears in the literature. However, the research itself is fragmented and there is a gap in the application of the theory and its implications for clinical practice. The intention of this research was to extend the study of the experience of therapists with a focus on spirituality in clinical practice. The purposes for choosing therapists who identify themselves as Christians are several. Shafranske (1990) found that of those psychologists who responded to a survey (few psychologists responded to the survey so few conclusions can be drawn) the majority reported spirituality as personally relevant. Additionally, those who did perceive spirituality as relevant in their own lives were more likely to perceive spirituality as relevant within their clinical work. In fact, it appeared that the therapeutic perspective and understandings were regarded as either not relevant or seen through the 13 personal spiritual framework of the therapist rather then the clinical orientation of the psychologist. Shafranske (1990) posits that clinical work is affected significantly by psychologists' reliance upon their subjective experience as the template for understanding the client's phenomenal world. By limiting the study to therapists who shared a personal spiritual framework it was hoped that the final descriptions and themes were more robust. Additionally, I personally have a theistic worldview (see Appendix A) and was a part of the research from an inside view and perhaps could comprehend and articulate more clearly the experiences of the co-researchers who identified themselves as Christian. The study was not intended to separate therapists with differing worldviews, however. It was intended to assist all therapists in increasing their knowledge of working more sensitively and effectively within the area of spirituality and counselling sessions. A number of reasons have been indicated for the purpose and rationale of the current study, imperatives that have arisen from within and without the field of psychology. Psychotherapists in general need to learn methods to make spirituality a vital part of their practice. Christian therapists in particular, will benefit from finding a way to integrate their own spirituality meaningfully into their practice. Definitions Definitions of Spirituality Although in a phenomenological study, the lived experiences of the co-researchers detine the experience (in this case the experience of spirituality), the following definitions are offered to give the reader a broad sense of the term "spirituality" in the current psychological literature. The differences between religion and spirituality will be defined as well as the term "Christian therapist" as it pertains to this study. As Benner 14 (1991) states in his paper, "Counselling as a Spiritual Process," the ambiguity around the concept of spirituality is so great as to make the term in everyday language almost meaningless. He cites such differences between Zen Buddhists and Protestant Pentecostals where their shared interest in spirituality would have differences so great that dialogue would be quite difficult. Even when confining oneself to those who call themselves Christians, some understand spirituality as essential, while others propose an understanding of the Christian life devoid of spirituality. Although some of this difficulty can be overcome by carefully defining terms, much of the problem arises because "spirituality brings us up against some of the complex mysteries of our being" (Benner, 1991, p.7). Elkins, Hedstrom, Hughes, Leaf & Saunders (1988) describe several components of spirituality that arose in discussion with professors and students in conjunction with the development of the Spiritual Orientation Inventory (1988). They explicate their definitions as being based on the writings of Abraham Maslow, John Dewey and William James. The factors they agreed upon were; that there is a transcendent dimension to spirituality, that it has to do with meaning and purpose in life, that there needs to be a sense of mission in life and an understanding that in losing one's life, one finds it. There is a sense of sacredness in all of life, in that all of life can be infused with sacredness, that all can be sacrolized or religiousized. There is a knowing that material values, although appreciated, cannot quench an ontological thirst, but that ultimate satisfaction comes from spiritual things. In the spiritual, there is knowledge of ourselves as interdependent, as touched by others' pain, as being our brothers' or sisters' keeper. There is a sense of idealism, a commitment to the betterment of the world, a loving of what is and also what can become, a commitment to the actualization of positive potential in all aspects of life. 15 There is an awareness of the tragic, of the realities of suffering and death in the human experience. There is an existential seriousness towards life that then enhances spiritual joy, appreciation and the value of life itself. Finally, there are fruits of spirituality that have a noticeable effect on one's life and relationships to all of life and whomever one considers ultimate. Chandler, Holden and Kolander (1992), in their article on counselling for spiritual wellness, define spiritual as "pertaining to the innate capacity to, and tendency to, transcend one's locus of centricity, which transcendence involves increased knowledge and love" (p. 162). This and the previous definition come from a humanistic, transpersonal perspective/Each of these definitions rings true from a phenomenological perspective, although a theistic view emphasizes a relationship with God as a primary pait of one's sense of self-transcendence and spirituality. The following definitions emphasize this perspective. Fukuyama and Sevig (1997), in writing about spiritual issues in counselling and training counsellors, use the definition of spirituality as a reference to an individual's search for meaning and value in life and his or her relationship with a transcendent power. Groeschel's (1993) book, Spiritual Passages, defines the spiritual life as the "sum total of responses one makes to what is perceived as the inner call of God" (p. 4). He goes on to comment that the spiritual is not locked up inside the person but is a "growing coherent set of responses integrated into the complex behavior patterns of human life" (p.4). It is not something apart from everyday life. Spirituality is relational both horizontally (between self and others) and vertically (between self and God or a higher power) (Groeschel, 1993; Benner, 1998). Benner (1998) suggests that spirituality is a human response to God's gracious call 16 to a relationship with Him, and is grounded in our having been created in God's image, designed for intimate union with Him. Alternately, Benner (1988) describes spirituality as our response to a mysterious human yearning for self-transcendent surrender. Benner (1998), in his book, Care of Souls, suggests Christian spirituality would recognize the pull towards self-transcendence, meaning, surrender, purpose, truth, perfection, belonging or the quest for the discovery of our deepest self that we share as humans, as a response to the call of spirit to spirit. "Made in God's image, humans are incomplete until they find themselves in relationship to the God who created them for intimate communion with himself (p.95). Christian spirituality embraces both success and suffering where openness to suffering is openness to spiritual growth and to the full experience of life. Lastly, Benner (1998) describes the expression of spirituality in Christian community. Hurding (1995) further defines Christian spirituality as living out one's connection and commitment to God in all the areas of one's life, being open to the Holy Spirit's influence, being ready to worship God and having a profound pledge to love and care for others. "Humans are incurably spiritual, spirituality defines our nature" (p.10) Anderson, (1994), describes spiritual experiences as transcendent, as representative of "a human capacity to be aware of a source of power and meaning that lies beyond ourselves and yet acts on us and within our concrete lives" (p.38). Spirituality is seen as a general search for and experience of meaning, for God and for others. Spirituality is an expression of yearning, for connections that we unconsciously recognize will clarify the meaning of our existence and secure our identity and its fulfillment. To be human is to be driven by a deep and foundational longing for coherence and purpose in life and one's identity. We seem to have a faint archetypal memory of the place where we belong and it 17 is somewhere other than self and involved in a relationship with someone Transcendent to self. Spirituality is an expression of a yearning for surrender. We need to be in the service of something or someone bigger than ourselves. At some level we seem to know the teaching - in order to gain our life, we need to lose it (Benner, 1991; Fukuyama, 1997' Groeschel, 1993). Richards and Bergin (1997), in their writings regarding a spiritual strategy in counselling, define spiritual as an "invisible phenomena associated with thoughts and feelings of enlightenment, vision, harmony with truth, transcendence, peak experiences and oneness with God, nature or the universe" (p.77). They define spirituality as "attunement with God, the Spirit of truth, or the Divine Intelligence that governs or harmonizes the universe". They further assume that being human includes spiritual capacities described as "ways of responding to, harmonizing with, or acting on the promptings, enlightenment, or sense of integration that may be associated with the Spirit of Truth" (p. 77). Definitions of Religion It is important to clarify the difference between religion and spirituality. As Bergin and Payne (1991) have suggested, therapists "will encounter more religious diversity than any other kind of diversity" (p. 200) and therapists need to be able to meet people at their level of spirituality. Grimm (1994), in writing about therapist spiritual and religious values in psychotherapy, defines spirituality as a reference to "a personal inclination or desire for a relationship with the transcendent or God, [whereas] religion refers to the social or organized means by which persons express spirituality" (p. 154). Worthington, Kuruusu, McCullough and Sandage (1996) have defined a religious client or counsellor as "one who holds primary beliefs associated with organized religion 18 and religious values" whereas they define spiritual as "believing in, valuing or devoted to some higher power than what exists in the world" (p. 449) Worthington, Karuusu, McCullough and Sandage (1996), in their ten year review of religion and counselling, have defined religion as applying to "any organized religion [where] religious beliefs are prepositional statements (in agreement with some organized religion) that a person holds to be true concerning religion or religious spirituality... a person may hold several religious beliefs to be true but not value those religious beliefs as important in his or her life" (p.449). Worthington et al (1996) differentiates religious from spiritual in that spiritual "generally is taken to mean believing in, valuing, or devoted to some higher power than what exists in the corporeal world" (p.449). In this sense, "a person may be spiritual but not religious (believing in and valuing, e.g. a universal human spirit or elan vital without holding religious beliefs to be true) or both spiritual and religious (believing in and valuing a higher power that is acceptable to and consistent with some organized religion)"(p. 449). The person could also be religious but not spiritual, holding to the doctrines of a religious organization, but not experiencing or expressing any devotion to a higher power (other than intellectual assent to its existence). The person could also be neither religious nor spiritual. Worthington et al (1996) also define religious counselling as primarily involving personal issues that use the content associated with an organized religion, explicit discussions of the impact of a person's actions on his or her religious beliefs or values, or the impact of a person's religious beliefs on his or her actions, or counselling done in an explicitly religious context, where consideration of religious issues might be normally expected to occur and do frequently occur. Furthermore, religious counselling techniques are counselling interventions that take into account a religion's unique characteristics 19 such as cognitive behavioural approach that takes into account Christian principles (Propst, Osturm, Watkins, Dean, & Mashburn, 1992) or interventions that incorporate a religion's practices (i.e. prayer with a client). Thus a religious counselor may hold religious beliefs to be true, value religion highly, and counsel a religious client, who also may subscribe to similar religious beliefs and value religion highly, but the counsellor may not do religious counselling, which deals with those religious values and beliefs explicitly. Legere (1984) indicated that spirituality is an experience whereas religion transforms a spiritual experience into a concept. Religion has a great deal of diversity whereas spirituality is universal, an integral part of being human. Spirituality is an experience of a relationship with a higher power, and can be independent of religion (Benjamin & Looby, 1998). Walsh (1999) defines religion as an organized belief system that includes "shared, and usually institutionalized, moral values, beliefs about God or a Higher Power, and involvement in a faith community" (1999, p.5). She further suggests that religions provide standards and prescriptions for individual virtue and family life grounded in core beliefs, and that congregational affiliation provides social and health benefits as well as support in times of crisis and a sense of a collective self. She contrasts this with spirituality, which she defines as a more overarching construct, referring to transcendent beliefs and practices, a more personal experience, and a more active investment in an internal set of values. The literature often uses the two terms of religion and spirituality interchangeably. In practice the terms have commonalties in experience and defining characteristics. As Wong (1998b) suggests, "as a personal subjective experience, religion and spirituality 20 can be used interchangeably". Because this is a lived experience study where participants are giving their experiences of the presence of spirituality in counselling, it is likely the two terms will be used interchangeably. When an element that is uncommon between the two concepts is being expressed, an effort will be made to articulate that difference. Definition of a Practicing Christian This study's participants were in part defined as practicing Christians. As noted many people in our Western society call themselves Christians. This study further limited that title to those who believe in and worship the God of the Bible and attend a Christian church. A Christian church is defined as any church listed in Derksen's (1996) British Columbia Christian Resource Directory 1996/1997. As the study was conducted with therapists who identify themselves as Christians and therefore have a theistic worldview, the major assumptions will be defined briefly, using the description provided by Bergin and Payne (1991). The three predominant assumptions are that God exists, that human beings are creations of God and that there are spiritual processes by which the link between God and humanity is maintained (Bergin, 1980). These assumptions are given with the understanding that the diversity within a Christian or theistic worldview is broad, with many views within each denomination. However, the major assumptions given are taken to be the core assumptions that can be agreed upon. This study was not researching "Christian therapy" where there is a deliberate use of religious tools such as prayer and bible reading. Because these tools are sometimes used by clients in their expression of spirituality, they are not excluded from the study, however, the study is focussing on the presence of spirituality in whatever form the experience of the therapist brought to the study. 21 Rationale for Methodology Qualitative methods are the most suited to the exploration of the presence of spirituality in counselling sessions. The topic of spirituality appeared to transcend the objective topics that are frequently studied in a scientifically quantitative way. This study utilized the existential phenomenological approach put forward by Colaizzi (1978), Giorgi (1975), Osborne (1990) and Polkinghorne (1989). The existential phenomenological approach focusses on the inner world of participants, describing human experience and attempting to understand that experience in terms of the structures that produce meaning in the consciousness of the participants (Pokinghorne, 1989). Farnsworth (1990) affirms this approach as the most effective for understanding and validating religious or spiritual experience. Because of the subjective nature of the experience that involves emotion and reason, it requires meaningful and personal participation of the experiences This study used in depth phenomenological interviews to elicit practising Christians' descriptions of how they experienced the presence of spirituality in their counselling sessions. The interviews were then analyzed. Significant statements, meaning units and common themes emerged and were checked for accuracy with the participants. Exhaustive themes and a common story were generated from a synthesis of all the participants' interviews. A more specific rationale for choosing the methodology and a more complete description of the process used is presented in Chapter HI. 22 CHAPTER n REVIEW OF THE LITERATURE Introduction A review of the literature on spirituality and psychological practice shows that there is a paucity of research regarding the experience of therapists having spirituality present in their sessions. The following literature review will begin with theorists who have struggled with the issue of spirituality and psychology and have made a positive contribution to our understanding of spirituality and its relationship to psychology. Buber (1970) and Rogers' (1980) view of therapy as a spiritual process leads into Tan's (1996) ideas of possible ways to integrate spirituality into therapy. A discussion of the research on mystical experiences and their relationship to spirituality follows. Developmental stages and spiritual growth stages shed light on the possible ways spirituality may make its appearance in therapy. The vantage points in development where individuals and families may find areas of spirituality more salient are focussed on next. Examples of areas where individuals have integrated recognized therapies such as 12 Step programs, cognitive therapy, psychodynamic therapy and family therapy with spirituality affirms the use of religious or spiritual strengths of clients within the strengths of recognized therapies. Finally, reviews of the literature of religion and therapy shed light on the areas of research that are needed and the possibility of this study furthering the research. Historical Theorists and Spirituality Already mentioned are theorists who saw religion and a sense of spirituality as a liability. However, psychology has always had a small number of professionals who have worked to bring about a serious study of religion and spirituality as a viability in the practice of psychology (VandeKemp, 1996). The theorists who follow, denied neither the 23 dark, irrational side of religion nor the historical atrocities committed in the name of religion. They did, however, see religion or spirituality as a necessary part of being wholly human. William James (1902/1985 found in Wulff, 1996) looked to religion as a way towards human excellence. James understood and rejected external religious practices which people engaged in, by rote and without thought. He saw these as opposing the genuine spiritual experiences from which these came. He interviewed a wide range of people and concluded that when inspiration and intellect combine in equally large measure, people can expect to attain levels of human excellence that cannot be otherwise observed. Additionally, he suggested that when individuals actually attain these levels, they would in turn inspire qualities of goodness in others that would then make the world an enhanced place to live. He came to consider religion as an essential part of life, performing a function no other part could successfully achieve (James, 1902/1985, found in Wulff, 1996). C.G. Jung's work (1969) was part of the analytical psychology movement. He saw religion as an important part of the human psyche and placed high importance on both religion and spirituality, considering both as central to the psyche (Clift, 1996;Thorne, 1998). Jung found religion to be pivotal to health and wholeness and a support to spirituality. From his work with mostly Protestant patients over a 30 year period, Jung concluded that, "Among all my patients in the second half of life.. .every one of them fell ill because he had lost what the living religions of every age have given to their followers, and none of them has been really healed who did not regain his religious outlook" (Jung, 1969, p.334). 24 The central concept in Jung's view of spiritual development is individuation. In individuation, Jung saw wholeness developing as a synthesis occurred between the ego (or consciousness) and the self (or the unconscious, which is the innermost part of a person, beyond the conscious). Jung saw the self as the true centre of the personality and the ego as a place where people differentiate. The problem for Jung, was that sometimes people get stuck in ego centredness. They never grow in their spiritual development towards their inner life and the life of the self as the center (Thorne, 1998). This movement or spiritual growth necessitates the integration of the complementary and conflicting parts of the personality into the self. In particular, Jung's work is known for the importance of integrating the 'shadow'. The shadow is incompatible with our conscious values and goals and is the suppressed part of our personality. During integration, these parts are united, bringing us to the point of being more authentic and more whole as persons. As Benner (1988) describes it, Integration, therefore is transcendence beyond the limited, selective, and even deceptive functioning of ego-centeredness... Jung felt that when we become aware of the opposites inherent in human nature, and in our own natures in particular, we then not only know ourselves, but we also know God (p.56). Jung saw the process of individuation as a submission of the ego will to God's will. Influenced by William James, Jung saw religion as a way to wholeness. Jung believed that the God image in spiritual growth is a component of the unconscious; that of the archetype of the self and the integration of this God image into the rest of the personality represents spiritual growth. Other contributions to the psychology of spirituality are many. Jung saw dreamwork playing an important role in exploring our deep inner worlds and as a way of becoming in tune with religious archetypes that were meaningful 25 messages towards our growth. Jung removed religion from the realms of neurosis where Freud had put it, to the place of honour as a creative expression of the innermost self. He also gave honour to the symbols of religious life as hope (Thorne, 1998, Helminiak, 1998, Benner, 1988). Kierkegaard (1941) is often called the father of existential psychology. He saw life as a quest to achieve personhood. For Kierkegaard, to be human is to be spiritual, to be spirit. Selfhood is the process of becoming a self-conscious responsible agent, a self-relating to the self. This relationship referred to self-acceptance, self-understanding and self-consciousness. True selfhood for Kierkegaard comes when one realizes one's dependency and surrenders to God. That then serves as an integration to all other parts of oneself. Kierkegaard's view of this development is one of synthesis of the opposites of finite and infinite, of the temporal and the eternal, of freedom (things possible) and necessity (things necessary) (Evans, 1990). Human life involves constant effort to maintain itself as authentic and if this tension lets go, in an attempt to escape anxiety, Kierkegaard believes that the true self is destroyed as an unbalanced self develops, which inevitably leads to despair. Either the self avoids becoming oneself, or one is willing to be a self but in defiance of God, both of which lead to a form of despair, and a true self is never realized. Kierkegaard suggests that "the more conception of God, the more self; the more self the more conception of God. Only when the self as this definite individual is conscious of existing before God, only then is it the infinite self (p. 211) (Evans, 1990; Kierkegaard, 1941). Kierkegaard's work bears a resemblance to Jung's work in that both emphasize self-knowledge and a synthesis of the parts of being human even though there is a spiritual struggle to do so. Unlike Jung, Kierkegaard emphasizes the centrality of God in a healthy self. 26 Gordon Allport (1950, found in Wulfe, 1997), an influential humanist, contributed significantly to the psychology of religion by studying the difference between extrinsic and intrinsic religious orientations. He was disturbed regarding research that showed the positive association between religiosity and a variety of prejudicial attitudes. His experience led him to believe that a genuine religious person would be opposed to these attitudes. From this he developed a measure that distinguished mature, intrinsically oriented religious individuals from those wh^> had an extrinsic orientation. He saw an intrinsic orientation as possessing six distinct traits: a) it is well differentiated, b) dynamic, c) independent of its childhood origins of needs, d) directive towards sustaining high ethical standards, e) seeks to encompass all of humanity within a unified framework and strives to bring discontinuities into a harmonious whole and f) despite uncertainty, it embraces religious faith as a premise which infuses life with energy and safeguards fundamental values (Wulff, 1996). Extrinsically religiously oriented individuals possess authoritarian, ethnocentric and other negative attitudes contributing towards their dysfunction. Modern Theorists and Spirituality A more modern theorist who sees the act of counselling as a spiritual process is Benner (1991). Benner's (1991) idea of spirituality flows from a definition of the human quest for and experience of meaning, God and other. He writes from a Christian perspective. He agrees with other theorists that spirituality is associated with an integration of internal life and external behaviour. He also agrees with other theorists that it is a moving beyond false selves. Unlike Jung, but like Kierkegaard, he sees that the integration of the person and the transcendence of false selves occur when the self is 27 dependent on God. Benner (1998) states that "only when self, or spirit, is grounded in Spirit do we find our true self, our self-in-God" (p. 86). He also views spirituality as surrender, where one is willing to be open to mystery. He sees God as communicating to the self in ordinary channels of rationality, or perhaps intuition, emotional or unconscious (dreams) channels. God uses the senses, imagination, reason, self-awareness and circumstances to communicate with humans. Benner (1988, 1991, 1998) sees humans as spiritual beings. He believes they are created for relationship with, surrender to, and loving service of God. He believes that life is about the choices one makes regarding how to respond to the Divine. He suggests that no one is nonspiritual. People still have spiritual yearnings that may have been cut off when distractions from the external world take their attention from their inner spiritual realities. Benner (1988, 1998) created a model of the differences in spiritualities. He called the first a nonreligious spirituality, where there is a quest for self-transcendence. Individuals are aware of their spiritual longings. The next layer is "religious spirituality [that] involves a relationship with the power or being who serves as the focus of self-transcendence and meaning for life" (Benner, 1998, p. 90). Religious spirituality includes prayer, meditation or worship. Within religious spirituality, he defines Christian spirituality as a place where responses to deep spiritual longings are carried out within the context of Christian faith and community. He states that "the essence of Christian spirituality is the deep relationship with God that occurs when the human spirit is grounded in the Holy Spirit" (p. 90). He sees spiritual growth as a movement into deeper relationship with God where our wills and character become increasingly conformed to God's will and character and we become whole, more our true selves, more fully human. In this way, he sees spiritual growth as closely related to psychological growth. "To grow 28 into deeper relationship with God is to find our place, identity, and purpose and to discover a point of reference for the integration of our personality" (p. 91). Chandler et al (1992), as part of transpersonal psychology, also offered a model which is helpful to place spirituality in the context of the whole person. They viewed the self as intellectual, physical, emotional, social and occupational. These five parts are further divided into two components, the personal and the spiritual. They theorized that the personal and spiritual are a part of each of the other elements and that the spiritual and the personal are interrelated and interactive with the intellectual, physical, emotional, social and occupational parts of ourselves. "Optimal wellness exists when each of these five dimensions has a balanced and developed potential in both the spiritual and personal realm" (p. 171). This article was not clear about the definitions of the personal versus the spiritual, however, their model adds to the idea of spirituality as it might be understood in a universal context in therapy. Counselling and Spirituality Martin Buber (1970) is well known for his book on dialogue and the I- Thou relationship. His ideas embody the spiritual in the everyday relationship. Although he perceived the therapist/client relationship as being neither capable of encompassing full mutuality, nor preferable that it do so, his thoughts on dialogue are important to clinicians. Buber (1970) saw humans becoming more human in the process of meeting, confronting, interacting and responding to each other. Buber (1970) was particularly interested in the betweenness of this meeting where something undefinable and transcendent was occurring where, when genuine openness occurs, there is "a Present Being between them" (Katz, 1975, p.420). Buber believed that it is through relationships and encounters that humans become whole. He believed that the person who is sick is an 29 isolated psyche, encapsulated within oneself, he is one who needs to enter into a healing relationship and be transformed. Through relationship, the person gains access to reality and to the meaning of his or her existence. Katz (1975) explains that "by human existence Buber meant a common sphere in which individuals participate but a sphere which reaches beyond the special spheres of each individual. It is this sphere which is realized in different degrees but which is for Buber the primal category of man's existence" (p.421). Buber (1970) criticized psychotherapy for not recognizing existential guilt where an individual is called to become the person he was intended to be and yet avoids that place. He suggested therapy reff ames this to bring comfort rather than recognizing the reality of the guilt as a place to begin healing the self. Katz (1975) looks at Buber's (1970) ideals of healing through meeting to indicate the possibilities for therapy through sensitive dialogue. The essentials he describes are to confirm and accept the other. If that confirmation can occur, the therapist can go on from there to offer redemptive confirmation or accepting the person as is and what they may become. Buber (1970) suggests the essence of making a person fully present is to be able to surrender oneself to full attention and openness to the other. Further to this process, Buber (1970) called for an embracing of the other where there is a turning to the other side, perceiving, responding as if he or she was on the other side. Buber (1970) made it clear that the difference in counselling between successful repair work and a regeneration of an atrophied personal centre was in this dialogue. The therapist was to have relationship where he or she is able to see both points of view and boldly swing into the life of the other, becoming exposed to the reality of the other's uniqueness, becoming fully aware and present to the other, feeling how the other feels. He came to believe that 30 "the healing of the spirit might begin and, through grace and love, be attained " (Katz, 1975,p.431). In a similar way, Carl Rogers' (1980) describes his person centered therapy. Rogers (1980) believed that if the therapist created the conditions of genuineness, unconditional positive regard and accurate empathic understanding that individuals would become growth oriented. In later years, he came to believe that the spirit of the therapist can perceive, respond to and help heal the spirit of the client in a manner of meta-empathy where there is transcendent spiritual enlightenment (personal communication found in Richards & Bergin, 1997, p.92). Meta-empathy is further described as the capacity to receive felt impressions and insights about clients that go beyond ordinary clinical hypothesizing or hunches. Models of Integration of Spirituality and Counselling Tan (1996) describes two major models of integrating spirituality into clinical practice: implicit integration and explicit integration. He describes implicit integration as showing respect and caring for clients while maintaining personal religious values in the practice of therapy, but not overtly or systematically using spiritual resources such as prayer or sacred texts in the session. The therapist may personally pray for healing and blessings for their clients, but are unlikely to do so aloud in sessions. If the client brings up issues which are spiritual in nature, they will likely be dealt with, but if the client wants to pursue spiritual issues more explicitly using spiritual resources such as sacred texts, or inner healing prayer, the implicit counsellor will likely refer the client. In explicit integration, the approach is to deal directly and systematically with religious and spiritual issues. A counsellor may use spiritual resources such as prayer, sacred texts or other religious interventions as well as referrals to churches or other 31 religious groups. This approach "emphasizes the spirituality of both the therapist and client as foundational to effective therapy and human growth and healing.. .[integrating] psychological therapy with some degree of spiritual guidance or direction in the therapeutic context" (Tan, 1996, p. 368). Tan cautions that explicit integration should be practiced in a culturally sensitive, ethically responsible and professionally competent way. He warns of the possible misuses and impositions that are possible in the explicit model and suggests that during intake, questions regarding the client's spiritual life be asked. If the client shows no interest in spiritual issues, this should be respected. Where spiritual issues are important to the client, clarification of how the therapist and the client will deal with these issues in session are important. This also gives the opportunity for the therapist to refer if they do not feel competent in an explicit integration model (Tan, 1996). Research Studies Showing the Effects of Religious/Spiritual Beliefs There are a number of research studies that show evidence of the incorporation of spirituality and religion as important in therapy (Richards & Bergin, 2000a). Research shows that religious and spiritual beliefs, practices and influences can prevent problems and help promote coping and healing where problems have already occurred. Understanding these influences can help therapists encourage clients in their beliefs and access more fully the resources offered by their religious communities. A twenty-year summary of these findings shows that people who are religiously and spiritually devout without being extremists enjoy more subjective well-being, psychological adjustment and physical health and lower rates of pathological social conduct than those who are not (Payne, Bergin, Bielema & Jenkins, 1991; Richards & Bergin, 1997). A precis of the findings is in the following list: 32 1. Religiously committed people tend to report greater subjective well-being and life satisfaction. 2. People who engage in religious coping (e.g. Praying, reading sacred writings, meditating, seeking support from religious leaders and community) during stressful times tend to adjust better to crises and problems. 3. Intrinsic (devout) religious people tend to experience less anxiety, including less death anxiety. They also tend to be more free of worry and neurotic guilt. 4. Religious commitment is usually associated with less depression. Among elderly people, church attendance is strongly predictive of less depression. 5. People who attend church are less likely to divorce. Studies have also consistently shown a positive relationship between religious participation and marital satisfaction and adjustment. 6. People with high levels of religious involvement are less likely to use or abuse alcohol. There is also extensive evidence that religiously committed people are less likely to use or abuse drugs. 7. Religious denominations that have clear, unambiguous prohibitions against premarital sex have lower rates of premarital sex and teenage pregnancy. 8. Religious commitment, as measured by church attendance, is associated negatively with delinquency. 9. Religiously committed people report fewer suicidal impulses, report more negative attitudes toward suicide, and commit suicide less often than nonreligious people. 10. Religious commitment is associated positively with moral behavior. Devoutly religious people generally adhere to more stringent moral standards, curbing 33 personal desire or gain to promote the welfare of others and of society (e.g. not gambling, drinking, or engaging in premarital or extra marital sex). 11. Intrinsic religious commitment is associated positively with empathy and altruism. 12. Religious commitment is associated positively with better physical health. Religious people have a lower prevalence of a wide range of illnesses, including cancer, cardiovascular disease, and hypertension. 13. As a group, religiously committed people tend to live longer and to respond better once they have been diagnosed with an illness. 14. People's religious beliefs can help them cope better with their illnesses, including a reduced likelihood of severe depression and perceived disability. 15. Religiously committed surgical patients have shown lower rates of postoperative mortality, less depression, and better ambulation status than patients with lower levels of religious commitment (Richards & Bergin, 2000a, p. 14). This research is not without its' conflicted findings. Spilka (1986) suggested that there are five possibilities when looking at spirituality in relation to function or dysfunction. Religion or spirituality may allow for or even sponsor the expression of abnormality. They may also act as a control or socializing force to suppress pathology. Spirituality or religion may function as a refuge, or protection from life's stresses or it may provide constructive directions for better relationships with others. They may also act as stressors that exacerbate existing weaknesses and problems. Pargament (1996) looked at the whole area of coping and religion and found four important variables that have an impact upon the process towards positive or negative. 34 The comprehensiveness of the coping process deals with whether religion provides support, meaning and reassurance to the person through the full range of experience, both the positive and negative of an individual's life. Related to this is flexibility to deal with generating new solutions, or new ways to think about problems, as well as personal and social change. Another index of effective coping of religion is whether the process is integrated. Are the coping processes suited to the demands of the situation? Finally, Pargament suggests that effective coping is also both benign and fruitful. The client's view of the universe is such that it is safe enough to venture into and to resolve problems and that effective coping leads to good things for the individual and for his or her community. Both Spilka (1986) and Pargament (1996) have contributed to the clarity of how and when spirituality may be helpful. Mystical experience (Geels, 1996; Hood, 1986) has also been studied as part of the spiritual in the psychological. This research informs psychology that when a mystical experience occurs, and the individual is provided with the support or the freedom to relinquish or surrender, there will likely be a profound movement towards transformation. Geels (1996), a Swedish researcher, studied spontaneous religious visions (these can also be nature visions) from a psychological perspective. He defines the elements of mystical experience as occurring in a religious or secular context that is then interpreted by the person as an encounter with a higher or ultimate divine reality. The experience engenders a deep sense of unity and of living on a different level than would normally occur. The experience also has far reaching consequences in the life of the experiencer. Geels (1996) used a qualitative method to analyze 35 case studies and a quantitative method in which he statistically analyzed 100 questionnaires. He organized his content analysis using a creative analogy with four phases. The first phase in mystical experience is preparation, where Geels (1996) found his informants had some kind of religious socialization and a degree of psychological stress or trauma. Second, he found that his informants went through a phase of incubation where there was a stage of self-surrender and a shift from a cognitive style to a more receptive mode, during relaxation or going to sleep. The third phase was illumination where Geels (1996) focussed on four dimensions of the religious visions. The emotional dimension revealed commonalties of intense joy, peace, security and love. The communicative dimension showed that the qualities of the visions were good. The perception dimension showed the visions were predominantly visual. The informants each interpreted their visions according to their own experience. The final phase that he called verification, was a profound sense of new life where their private dimensions of religion (which Allport would describe as the intrinsic dimensions of religion) increased to statistical significance (p. 203). He concluded that the religious vision establishes order in a chaotic system and functions as an adaptive process where the psychological system needs order restored. In an article on his own research on mysticism in the psychology of religion, Hood (1986) summarized his considerable research. His findings are first, that intrinsically devout persons (not necessarily church committed persons) are most likely to report religiously interpreted mystical experiences. Second, that psychopathology does not relate to mysticism and last, that various conditions trigger mystical experiences, depending on the beliefs of the individuals involved. He suggests that mystical experience is the fundamental experiential basis upon which religion rests. He also asserts that mystical experience is a universal experience and he sees religion as an interpretative frame for understanding mystical experience. 36 Anderson (1994) reports a case study of a couple who enter therapy after having years of difficulty in their relationship. The woman has a dream where she relinquishes herself to God and then experiences the incredible lifting of her negative feelings over the past months. She is left with a felt sense of a profound healing having taken place. She awakens with a sense of peace and a certainty that a change has taken place in her relationship. Anderson (1994) describes a model of human experience that embraces the four domains of time, space, story and transcendence. He describes time as the interactional events that occur in sequence, space as the way in which families organize the structure of their relationships and story as the ways that family members use language to shape what occurs in time and space. The transcendent dimension he describes as experiences occurring within time, space, and story that transcend our abilities to control, analyze or fully explain them, to be aware of a source of power and meaning that lies beyond ourselves and yet acts on us within our concrete lives. As with the above researchers, Anderson (1994) finds that relinquishment is an important component of these transcendental experiences. He suggests that therapists too need to adopt a stance of relinquishment. He describes this as a willingness to let go of our wishes and attempts to changes our clients' relationships and our willingness to feel our clients' despair and our own anxiety about failing to help. Holme's (1994) reports three case studies in relationship to the Internal Family Systems model. He describes the experience of a woman in therapy who had an epiphany in which she experienced a god within that resulted in substantial healing effects for her. He describes a second client experiencing a debilitating shame due to a previous abortion. She resolved this shame by reconciling the relationship with the spiritual part of herself. The third client dealt with depression and progressed through the comforting 37 presence of a spiritual part. Holmes (1994) discussed the difficulty a rational objective therapist (himself) has with understanding these experiences and yet realized the great need to connect people with their spirituality to bring about healing. He found that clients with strong spiritual lives readily connect to this part of themselves in the therapy room. Spiritual Assessment within Counselling In order to serve clients well and to bring about the possibility of the full expression of being human in therapy, Peck (1993) suggested that all psychiatry residents learn to do a spiritual history as well as the general intake history that they routinely study. He listed a number of possible questions relating to the individual's religion of childhood, changes in religion, an individual's notion of God, the relationship of the individual and God (how distant, how close) and changes in that distance, prayer and other spiritual experiences and their effect on the individual. Maloney (1989) looked at how religious assessment could be helpful in determining the way in which religion had an impact upon symptoms, the evaluation of personality strengths and weaknesses and the resolution of problems in the counselling context. To this end, he developed a religious status interview. Maloney (1996) further considered the way in which religious assessment can be applied to attempts at achieving a spiritual understanding of emotional problems and efforts to help people grow spiritually. He views spirituality in counselling as an area where persons can experience adjustment problems and uses Sarbin's (1970, found in Maloney, 1996) taxonomy of life environments which includes the transcendental to provide structure to the adjustment areas. The transcendental environment relates to "finding meaning in life in relation to the unseen, eternal reality which lies behind the material world" (p.246). 38 Maloney (1996) reasons that dealing with a client's spirituality is inevitable and that enhancing a client's spirituality helps persons cope in all of life's other environments. Maloney (1996) argues that spirituality is central to mental health and assumes spirituality to be "practically and intricately involved in day-to-day well-being" (p.249). Maloney (1996) gives an example of assessing spirituality in counselling as to whether it is important or active, good or helpful in a client's adjustment. Maloney (1996) then suggests the counsellor may use a number of options to deal with that information. The counsellor has the option to disregard the person's spirituality because it is weak or ill-formed so that it is having no impact in the person's life. Another option would be to annihilate because the person's functional religion was completely destructive and had become a part of their pathology. The reinstate option would be to consider that the client's spirituality was potentially helpful and to work towards making it more explicit and intentional. The encourage option would be to support and enhance an already active strength in a person's life. Maloney (1996) further developed his theory toward the opportunity of taking the initiative option in counselling towards spirituality where a gentle dialogue occurs around the issues of the pain and dilemmas brought to counselling within the deeper context of their estrangement from their centre of existence. In the correction option, counsellors may provoke insight into how more conscious development or application could induce sounder mental health. The reinstatement option may be used when counsellors recognize clients who have bifurcated their religion and their daily lives and may be helpful in connecting persons, once again, to their spirituality in daily life. Maloney (1996) suggests that counsellors need to take the option of encouragement of spirituality in their clients if they believe that becoming more spiritual means becoming more whole. Finally, Malony (1996) 39 suggests watching for unique moments in counselling when individuals can experience a transformational moment where "their problems are seen in a new light and the possibility of a move toward "Godly" living becomes possible" (p.257) Development and Spirituality within Counselling Worthington (1989) looked at predictable ways in which clients might be looking at religion or spirituality as part of a developmental process. He saw development of children as relatively predictable and best described by a stage development process. However, he saw models of transition and crises as better describing adulthood's religious development. He summarized developmental theorists' processes and the variety of points where religious influences and spiritual reflections may become more salient to clients. He also looked at religious issues across the lifespan that therapists will typically confront. It is in these issues that clients may be stimulated to address spirituality or religion in their lives and in the therapy room. Counselling children and their families may involve children learning to deal with death and developing a concept of God. Children also learn the practice of self-discipline that has many implications of their parent's religiosity and parenting styles. Adolescence has three important issues where religious influence is likely to be involved. These are identity, sexual orientation and alcohol and drug abuse. In young adulthood, work and its religious meaning are important as well as issues of singleness, marriage and parenting. Middle adulthood brings career consolidation and developing an unselfish care for the future, family care and interiority and personal reflection. Quests for meaning in both men and woman have been found to be a part of this stage and present an impetus for spirituality to be part of counselling. Older adulthood brings increased religiosity and concerns with issues of death. Worthington (1989) suggests that each era of life is filled with transitions and life 40 events that bring about a sensitivity to spiritual issues. He suggests that anticipating these issues in counselling and combining this knowledge with spiritual development will be helpful to clinicians. Groeschel (1987, 1993) exhorts therapists to be aware of the development of spiritual growth as the "stage a client is passing through may profoundly affect [their] attitudes and behavior" (1987, p. 103). He views the first stage in the spiritual journey as awakening when a profoundly moving experience of transcendent reality comes to someone who may not even expect it. Stage two is moral integration where there is a painful struggle to bring behaviour into agreement with moral conviction and where the person overcomes infantile narcissism. Stage three is mature faith where the struggle to pass beyond the rational informed explanation of one's religious convictions and the willingness to accept the mysterious elements of faith represent the relinquishment of adolescent curiosity. Stage four is trust or hope representing the relinquishment of the need to control God and the events of life by one's own behaviour. Groeschel (1987) views this step on the spiritual journey as transcending "the narcissistic and cultic behavior of childhood religion, and the profound anxiety characteristic of children faced with unmanageable fear" (p 103). The final step is enlightenment and union with God. Groeschel (1987) believes this stage is rare and even rarer do individuals in this stage come to counselling. A contemplative spirit and a sense of gentle kindliness and generosity pervade the relationships of people at this stage. Groeschel (1987) states that "a person growing in the spiritual life may experience the same problems as any other client" and does not preclude conflicts and serious problems. He sees someone on a spiritual journey as being more open to others, less defensive, more aware of personal feelings and more compassionate and generous. 41 Genia (1995) identifies five phases of psychospiritual development. The first stage is egocentric faith where people magically identify with an omnipotent Other or try to appease a sadistic God. Magical thinking and comfort seeking are a part of their religious expression and individuals in this stage are likely to use the religious arena to reenact their emotional traumas. The second stage is dogmatic faith where individuals try to earn God's love and approval. They are fearful and excessively guilty about sexual and angry feelings. They are characterized by self-denial, submission to authority and intolerance of diversity and ambiguity. The third stage she develops is transitional faith where individuals critically examine their previously held spiritual beliefs and values and begin to reformulate them. Until they become anchored in a faith that is congruent with their ideals, they may feel spiritually groundless and confused. Those who are committed to a self-chosen faith that provides meaning, purpose and spiritual fulfillment characterize stage four in which internalized morals and ideals guide spiritual practice. The ideological consolidation of this stage may prevent new spiritual insights toward further progressive transformations. The fifth stage of spiritual evolution is one that Genia (1995) believes few people attain. It is characterized by selfless devotion to goodness and truth. These individuals are able to experience a sense of community with people of all faiths and with God. They fervently strive to fulfil the highest potential in themselves and humankind. She relates with compassion the experiences of individuals in each stage of spiritual evolution and suggests possible pathology and psychotherapy for each stage. Fowler (1996), a well-known theorist in faith development, describes seven stages of faith and their relationship to a growing selfhood. These include the complex interplay of biological maturation, emotional and cognitive development, psychosocial experience and religious and cultural influences that effect faith development. He describes the ties 42 of religious tradition that can include "art and architecture; symbols, rituals, narrative, and myth; scriptures, doctrines, ethical teachings, and music; practices of justice and mercy; and much more" (Fowler, 1996, p. 168) that helps to form and effect the awakening of faith. Fowler (1996) characterizes faith as an integral, centering process, underlying the formation of the beliefs, values, and meanings that: (a) gives coherence and direction to people's lives, (b) links them in shared trusts and loyalties with others, (c) grounds their personal stances and communal loyalties in a sense of relatedness to a larger frame of reference, and (d) enables them to face and deal with the limited conditions of human life, relying on that which has the quality of ultimacy in their lives (Fowler, 1996, p. 168). Fowler's stages, like other constructive developmental stages are invariant, sequential, and hierarchical. Beginning in infancy the stages begin with the conflict of trust, and then like Genia's (1995) stages, move to embrace the polarities and paradoxes of life to a universalizing faith where there is a spending of self in love (Fowler, 1996). Counselling Processes and Spirituality A number of counselling programs, both lay programs and recognized therapies, have been modified to take into account the spirituality of persons. One example of a treatment orientation that has always had a spirituality component, is the 12-step program. Hopson (1996) reports that it is the most widely used form of treatment and is unique in that it originated in a religious tradition and it continues to rely on spiritual principles. Spirituality in the 12-step program involves an acknowledgement of one's helplessness which then leads to the recognition that one must turn to something outside of oneself as well as bring one's will and behaviour in line with the reality of one's 43 condition. This leads to the process of recovery. The program names the something outside oneself as the Higher Power. Hopson (1996) states, "Recovery is made possible at the junction between the surrendered self and the higher power. The quest that has compelled someone to use a substance is redirected toward the beneficent higher power" (p.537). The 12 Steps are summarized as; Steps 1-3: Give up, Steps 4-7: Own up, Steps 8-9: Make up, Steps 10-12: Grow-up. Although there has been criticism of the dependency on the Higher Power, the 12 Step Society continues to believe that any attempt to remediate lifestyle problems must address the spiritual. They see that beneath the problem of addiction "lies the more general and persistent problem of human living: the negotiation of our finitude" (p.553). They offer a community in which to do this that gives structure without the institutionalism. Propst (1988, 1996) also offers interventions that allow the use of an individual's spiritual strengths and frameworks. She presents a cognitive behavioural approach that uses scripture and theological reflection, including religious imagery, in cognitive reframing. She presents the findings of two case studies, one individual and one group experience, that tested the efficacy of the methods and found positive results. Rizzuto (1996) presents a psychoanalytic approach that appreciates the intangible reality of the sacred. She looks at the contributions of faith and presents cautions for both the therapists in counter transference issues with their own faith, as well as the resistance of clients to face transference issues because of their faith. She develops the meanings that are disclosed within religious symbolism, language and experience. She looks at God representations and does not attempt to modify religious ideation as the example of Propst (1996) above, instead, she seeks with the client the dynamic meanings and conflicts that are part of these ideations. Family and couple therapy also has recognized 44 the significant influence of a spiritual orientation in marital and family systems. In the view of Sperry and Giblin (1996) and Walsh (1999), religion plays a crucial role in determining the beliefs and values of families and perhaps motivates them to participate in a faith community which further influences the family. Conflicts in marital relationships are often value conflicts and family therapists will often recommend a religious background assessment and perhaps even a spiritual genogram to find resources for healing in the couple and family system. Worthington, McCullough, & Sandage (1996) did a ten-year review of the empirical research of religion and psychotherapeutic processes and outcomes. They did not review articles stressing spiritual aspects, such as 12 step programs that they described as promising areas of consideration but limited their study to religious aspects of counselling only. They found that the research has focussed on potential, not actual clients with only a few studies that investigated the role of religion in client's lives during their counselling. They found the same with the counsellors themselves. As well, they discovered that with the rise of multiculturalism, as a fourth force in psychology, there is a religious pluralism. This "forces counselors to deal with many religious traditions and to formulate positions about the interaction between their own religious beliefs and values and those beliefs and values of their clients" (p.479). They also suggested that theories are needed that are broader than those within a single religious tradition. By studying a variety of therapists who deal with diverse clients while holding their own Christian beliefs, it was hoped that the current study would illuminate this interaction. Also, in having therapists share their experiences of making spirituality present in counselling, rather then explicit religious interventions, it was hoped that this study would contribute to the broader scope of spirituality. 45 Finally Holden (2000), whose work has focussed on near-death, mystical and other nonordinary experiences, put out a call for counsellors' accounts of their clients' spiritual experiences. Holden found that not only were mental health professionals willing to describe their clients' experiences, they also wanted to describe his/her own spiritual experiences in counselling and did not have a forum to do so. This research will in some measure begin to fill that gap. Conclusions A number of areas related to spirituality have been reviewed. Although there was no research found specific to the current experiential research, the articles add to the growing body of writings that are valuable in understanding this complex topic. The review showed the positive aspects of spirituality in peoples' lives and the validity of bringing the subject forward as part of counselling. The review also showed the need for the topic of spirituality in counselling to be illuminated by counsellors who are currently experiencing the presence of spirituality in their sessions. CHAPTER TH METHODOLOGY Introduction The phenomenological method's aim is to give voice to the perceptions of human experience with all types of phenomena. Counsellors, the practice of counselling and the research questions that evolve from clinical practice are enmeshed in the life experience of people, making the fit of the phenomenological method exemplary for the investigation of the phenomena chosen. Phenomenological research (as one of the designs of qualitative research) emphasizes the "discovery, description and meaning rather then the traditional natural science criterion of prediction, control and measurement" (Osborne, 1994, p. 169). The phenomenological method allows researchers to explore existential areas of being human that were formerly inaccessible because of the objective rigidity of the experimental method. The phenomenological method investigates and legitimizes the inner human experience, respecting the fact that the person experiencing the phenomena is most consciously connected to the lived experience and therefore is in the best position to describe the lived experience of the phenomena (Osborne, 1990). The differences in assumptions between a phenomenological approach to research and an experimental approach, according to Cresswell (1994), are as follows. Regarding the ontological assumption that concerns the nature of reality, the quantitative paradigm accepts that reality is objective and singular and apart from the researcher, whereas the qualitative paradigm accepts that reality is subjective and multiple as seen by all participants in the study. Regarding the epistemological assumption, which concerns the relationship of the researcher to that which is being researched, the quantitative paradigm 47 holds that the researcher is independent from that which is being researched. The qualitative perspective is that the researcher interacts with that being researched. In the axiological assumption where the role of values is concerned, the quantitative stance accepts a value free and unbiased paradigm while the qualitative stance accepts research as value laden and biased. Differences in the rhetorical assumption around the language of research are seen where the quantitative method uses a formal, impersonal voice that is based on set definitions and the use of quantitative words. Qualitative methods use a more informal, personalized voice and decisions in research are evolving using accepted qualitative words (Cresswell, 1994). Methodological assumptions in the process of research include numerous disparities. Quantitative research is based on a deductive process that looks for cause and effect. The design is static where categories are already determined before the data is collected and where there is an effort to make the research context free. The purpose of the research is to confirm generalizations that will lead to prediction, explanation and understanding. The research is made accurate and reliable through procedures to strengthen the validity and reliability of the study. Conversely, the methodology of qualitative research rests on the assumptions that research is an inductive process where there is a mutual shaping of factors as the research progresses, where there is an emerging design and where themes and categories are identified during the research process. The research is assumed to be context bound and the purpose is to discover patterns, leading to theories that are developed for understanding. The research is made credible and trustworthy through verification (Cresswell, 1994). Merrian (1988) adds the assumptions that qualitative researchers are interested in meaning, how people make sense of their experience. In qualitative research the primary 48 instrument for data collection and analysis is the researcher herself, rather than questionnaires, inventories or machines. Qualitative research is also descriptive where the researcher is interested in the understanding gained from words or pictures that are presented. Research Design The choice of phenomenology to research the presence of spirituality within counselling sessions originated from several understandings. Examining the literature has shown multiple articles, books and reviews of books on the subject of spirituality and counselling. However, there are very few actual research studies on the existent experience of the spirituality of humans and how therapists are or can penetrate this area of humanity for growth and change. The current research question lacked sufficient basis to use a quantitative design. Hearing therapists' personal stories and reading the research on the challenges of integration showed the very real discrepancy between peoples' experience of the phenomena of spirituality and the practice of counselling. This discrepancy provided existential validation for the need for qualitative research aimed at increasing our understanding (Van Manen, 1990). Additionally, as previously discussed, the objective science of psychology from the time of Watson (1913, found in Kalat, 1986) and religious or spiritual experience have been uncomfortable together. Methodology played a large part in this as has been discussed. The scientific paradigm does not lend itself to numinous topics such as spirituality, whereas qualitative research opens the doors to studying these experiences. Qualitative research rests on the assumption that experience is existentially significant, legitimate, and a necessary content for understanding human psychology (Anderson, 1995; Colaizzi, 1978;Giorgi, 1992). 49 Additionally, the choice to use a qualitative method rests on a Christian tradition of finding truth in human experience, and in the case of this study, there is an emphasis on processes that are not easy to observe in the traditional scientific way (Bergin & Payne, 1991, p. 204). The choice to study Christian therapists rested on a several factors. One is personal curiosity related to my own experience, as well as conversations I have had with my Christian colleagues about their own experience of religion, spirituality and counselling. Although identifying oneself as Christian is to identify with variant beliefs and diversities in traditions and religious norms, there is also a shared value system among Christians. As counselling is value laden, it seemed important to find out what the experiences of making spirituality present in this particular group of professionals was like. Also the current socio-political climate, which appears to be concentrating on learning to accept minority religious views, inclines me towards hearing the voice of my own culture's Christian heritage which has not had the opportunity to be aired in the historical climate of psychology. The statement that the current research was well suited to a qualitative design rests on a number of reasons, as noted; a) there is a lack of previous research on the concept of spirituality in counselling sessions; b) there exists a need to increase the understanding of spirituality in counselling sessions both from the perspective of counsellors' needs and from the enhanced interest in society; and c) the nature of spirituality as a phenomena is not well suited to quantitative measures. Procedure Qualitative research has a number of steps that are common to phenomenological research and are identified by Colaizzi (1978), Osborne (1990) and Polkinghorne (1989). 50 These steps include: (1) Framing the Question; (2) Bracketing; (3) Selection of Co-rescarchers; (4) Data Collection; and (5) Data Analysis. The process of these steps will be included below. Framing the Question Framing the question to begin interviews, follows the guidelines of phenomenological principles. Colaizzi (1978) demonstrates Husserl's precept of returning to the things themselves in order to study a phenomena in a meaningful way (p. 56). He suggests that the success of the questions we ask in research increases to the extent that the participant is able to relay the experience of the study, rather than the theoretical knowledge of the experience. For this reason, the question 'what' rather than 'why' was used (Valle, 1989). The research question was derived from the general research problem - 'What is your experience of the presence of spirituality in your counselling sessions?' Empathetic responses and probes are used as needed to further enhance the detail, contextual understanding and meaning of the experience for the participant. Bracketing Bracketing is an important part of the existential phenomenological method (Ashworth, 1996; Giorgi, 1997). It is a process of attempting to recover original awareness or the perception of a phenomena (also called reduction). Phenomenological research, unlike traditional scientific research, recognizes that the investigation of a phenomena and the life world which participants experience is very much an interpersonal process. To be true to the goal of understanding the lived experience of informants, a requisite for a researcher, is to suspend personal beliefs, assumptions and biases regarding the phenomena under investigation (Streubert and Carpenter, 1995). 51 Historically, bracketing arose from Husserl's idea that in order to participate in the phenomenological method of research one needed to transcend one's self to a state of pure consciousness in order to reveal the lived experience in a true way. Later, Merleau-Ponty interpreted Husserl's ideas. He suggests not holding oneself away from the lived experience or trying to reach some detached consciousness in order to have a more true experience of the data. Rather he proposes a search within oneself to come to know the theories, presuppositions, interpretations and beliefs one holds about the phenomena being researched and a putting aside of these in order to allow the data to speak for itself (Ashworth, 1996; Giorgi, 1997). Bracketing helps to bring one to a place of openness. It is a continuous process throughout the research in order to hear the lived experience of the participants as it really is. The types of predispositions and assumptions that need to be bracketed are those gained from reading the theories and research regarding the phenomena as well as those based on personal experience. Making these assumptions explicit to the reader enables the reader to judge how well that perspective has illuminated the subject (Osborne, 1990). A brief synopsis of some of the personal insights gained through bracketing is presented in Appendix A. Selection of co-researchers Opportunistic sampling was used to select participants for this study. Co-researchers who met criteria were recruited through networking contacts. A letter of invitation (Appendix B) was sent to potential participants. The letter provided a brief description and the criteria required to take part in the proposed study. The letter gave potential participants the opportunity to call and indicate their interest. The initial telephone call confirmed inclusion in the study using the criteria for selection and the 52 potential participant's willingness to complete the descriptive interview. Preparing participants for the coming interview, as well as the opportunity for any questions they may have, was attended to as well (Streubert & Carpenter, 1995). The aim in the selection of co-researchers was to choose therapists who identify themselves according to the following criteria: a) those who identified themselves as trained professionals in the area of counselling; b) those who identified themselves as Christians and who were involved in a Christian church; c) persons who have experienced the phenomena of the presence of spirituality in their counselling sessions; and d) persons who were able to "illuminate the phenomena" (Osborne, 1990, p.82). An effort was made to hear the lived experience of therapists from a variety of settings. Choosing counsellors who worked in a diversity of settings, such as private practice settings, secular community agencies and Christian counselling agencies, may have extended the aspects of the experience of spirituality in the counselling context (Polkinghorne, 1994). Data collection The first interview clarified the informed consent (Appendix C) which was signed. Permission was obtained to tape record the interviews. The aim of the interview was to "describe and understand the meaning of the central theme of the experience being investigated" (Polkinghorne, 1989, p.49). The interview was unstructured and open-ended. As the interview progressed, empathy and clarification was used to deepen and continue the description of lived experience. When the participants had difficulty in relaying their experiences and reached endpoints in their dialogue with the researcher, the researcher prompted the participants with gentle probes in order to elicit the participants' responses in as much detail as possible. Specific 53 information about the interviews and the researcher / interviewer is provided below. Researcher Considering the researcher as an instrument or tool is part of the philosophy of the human science method. I am a middle-aged female who has life experience in the area being studied (see bracketing in Appendix A). Additionally, I have been practicing as a volunteer counsellor for 8 years, as a mental health clinician and as a therapist in a private practice for approximately 5 years. This has given me interviewing experience that is relevant to this proposed project. Interviews The interview process was informed by methods proposed by Colaizzi (1978), Osborne (1990) and Weiss (1994). There was a brief telephone interview, an in-depth personal interview, plus a follow-up interview with each participant. The initial telephone contact was at the instigation of the participant in response to a letter of invitation to be a part of the proposed study. An initial rapport was established. The inclusion criteria were confirmed in this initial telephone call. Demographic details of the profiles of the co-researchers were collected in order that readers and researchers may understand the experiences of the participants in the context of their lives. The nature of the study and any questions the participant had were also dealt with at this time. The consent form was described. A time and a place for the interview at the convenience of the participant was arranged. The in-depth personal interviews ranged from one to three hours long and were devoted to data collection. They were audio tape-recorded. After introductions and a brief discussion of the nature and purpose of the study, the interview began with a description of the consent form and the confidentiality issues related to the study. The 54 participant was invited to ask any questions. After giving time for the participant to review the contents of the consent form, he/she was asked to sign the consent form. The main interview question was used for the data collection. The initial statement was approximately as follows: 'Please think back to a time or times when you had a meaningful experience of having the presence of spirituality in your counselling sessions. Please describe as fully as you can your experience where spirituality in counselling accurately describes this event or events.' Active listening responses were used to facilitate further elucidation of the participants' responses. Probes such as, "Tell me more" or "Tell me more about how that relates to spirituality for you" (Appendix D) were used to help the participant to give a full description of their experience. After the data analysis was produced from the in-depth interviews, a final interview of approximately 30 minutes took place. At this interview, the individual meaning units elaborated from the significant statements were confirmed by the participants and their individual themes were checked for veracity to their experience. Each participant was asked the questions (see Appendix F) similar to those recommended by Colaizzi (1978), "How do my descriptive results compare with your experience? [and] Have any aspects of your experience been omitted?" (p.62). Field notes were taken at these final interviews and corrections were noted and formulated into the final descriptions. Data analysis Data analysis was accomplished by using the steps presented by Collaizzi (1978) and Georgi (1975). The goal of the phenomenolgical data analysis was to categorize the investigated experience into meaningful themes that would describe and define the essential structure of the phenomena. Step One: After collecting participants' experiences on tape (protocols) and transcribing them, the researcher repeatedly read the participants' descriptions or protocols as a whole "in order to make sense of them" (Collaizzi, 1978. p.58). Step Two: The researcher returned to the participants descriptions to search for significant statements or phrases that directly pertained to the experience of the presence of spirituality in counselling and separated these from the data. Repetitions were eliminated (although these were noted for significance), and specific statements were made into more general points, all the while checking to make sure the changes continued to reflect what the data was saying. Step Three: The significant statements were read and restated to frame meaning units from the data. This process moved from what the participants said to what they meant, going beyond their words but still staying within their meaning. It meant being careful to make sure the data still spoke for itself, but illuminating the meanings in the data. The attitude of the researcher at this point was one of openness, not allowing the purpose for the research to dictate the natural meaning units uncovered. Step Four: After revealing the meaning units from each of the participants' descriptions, the meanings data was explored for commonality and clustered into themes which were common to the co-researchers. When themes emerged from the clustering of the meaning units, these themes were referenced back to the original protocols to validate that the themes 56 were still true to the lived experience of the co-researchers. Questions were asked at this time concerning whether there was anything in the original data which was not accounted for in the themes or whether there was anything in the themes which was not implied in the original protocols. Continuous refinement and re-examination occurred as the final themes were clarified. Step Five: The results of the work of analysis thus far was integrated and written into an "exhaustive description"(Colaizzi, 1978, p.61) resulting in Chapter FY. Formulation and the description of the themes depended upon quotations and examples from participants' protocols. Step Six: Taking the exhaustive description, an effort was made to make a veridical statement of the fundamental structures of the phenomena. The analysis thus far was synthesized into the most common and concise story. It illuminated the experience of having spirituality present in counselling by participants in the study. The principal researcher as well as two peer reviewers examined the data for discrepancies or inconsistencies between the results of the analysis and the experience of the participants as it was relayed to the researcher. Step Seven: At this point, the analysis of the phenomena found in step six was validated by returning to the participants to verify that the significant statements, meanings and themes matched the participants experience. Changes that participants offered at this time were worked into the final analysis of the research work. Ethical Considerations Several steps were taken by the researcher to ensure that the current study was carried out in an ethical manner. All of the procedures were evaluated and sanctioned by the University of British Columbia's Ethical Review Committee. The manner in which the participants were invited to be a part of the study is included in Appendix B. A consent form (Appendix C), indicating the expectations of the study and the participants rights, was included and signed before the participants began the interview process. All identifying data was confidential and a first name pseudonym was used in a write-up of the study. The participants were kept informed about the data collection process and questions were invited and answered. Any information that may have been considered sensitive was checked with participants. Reliability and Validity Natural Science is explanatory science while the existential-phenomenological research used in the proposed study is descriptive science (Giorgi, 1992). Reliability and validity are terms that come from natural science rather than a human science and are used as checks and balances, to make sure a study with a goal to statistically generalize results to a theory or model, will be viable. Part of reliability in natural science is based on a single reality. That means that the same research will give the same results. Validity in naturalistic science is the degree to which the instrument measures what it is designed to measure. Reliability and validity in phenomenological research will be described below. Reliability In qualitative research, reliability is based on the understanding that human perception is perspectival and contextual (Osborne, 1990). Although different 58 interpretations may come out of a phenomena, these "multiple perspectives ... can lead to a unified description of a shared phenomenon" (p.87). Reliability occurs when there is consensus regarding the essence or meaning of the experience with other researchers. Reliability was met by agreement with the student researcher as well as the principle researcher agreeing on the analysis of the data. External reliability was met by having two independent reviewers who randomly examined transcripts for significant statements and analyzed the meanings for agreement with the student researcher. Validity Validity is gaining an understanding of the meaning and attributes of the phenomena as a lived experience as accurately as possible. This was achieved by the use of bracketing by the principal investigator, by peer examinations throughout the process and by checking with the participants that the meaning and description of their experience was captured. Trustworthiness Guba's (1981) model of trustworthiness or merit in qualitative research is the model that this research has had as its aim. The first part of the model looks at the truth value of the research. The criteria for the truth value rests on whether the findings have been participant oriented and not defined by the researcher. The reported bracketing (Appendix A) is helpful in assessing this. Truth value is also assessed on whether the research is representing multiple realities and whether individuals who also experience the phenomena resonate with the findings described in the research. Checking back with participants at the point of significant statements and meaning units as well as investigating whether the themes expressed the participants' experience of the presence of spirituality in counselling confirms the truth 59 value. Having peers assess the themes for resonance with their experience of the presence of spirituality in counselling added validation to the truth value (further information on the investigator triangulation of the study follows). The second part of the model looks at the applicability of the research. Although each situation of lived experience is unique, a thorough description of the contexts of the participants reporting, and presenting sufficient descriptive data, will allow other researchers or readers to determine transferability by the similarity to the situations being looked at. This research provided profiles of the researcher in bracketing, as well as profiles of the participants in a general sense, to preserve confidentiality and in a particular sense, in order to provide information for the area of transferability. The third part of the model concerns consistency. There is a belief in human research that there are multiple realities in lived experience. Rather than control for subjects in the design of the research as in a quantitative paradigm, in a qualitative design, there is a sense that both the researcher and the informant are the instruments in the design and both vary, emphasizing the uniqueness of being human. Within this, there must be a dependability that shows the tractability of the variability in the research. This research attempted to identify the sources of the variability encountered. Bracketing and pro tile information was identified so that the variability could be illuminated. The fourth part of the model concerns neutrality. Unlike natural science, that considers neutrality as freedom from bias, where findings are solely based on subjects and the conditions of the research, human science regards neutrality as a decrease in the distance between the researcher and the participant. The least amount of distance the greater the worth of the findings. Strategies that can increase the trustworthiness of the research were a commitment 60 to one telephone contact and two meetings with participants. This helped to ensure that the threat felt by revealing information of a personal nature was less susceptible to errors of preferred social responses. A variety of data sources were sought to maximize the range of data. This would likely give a more complete picture of the phenomena sought, recognizing that individuals attend to only a part of their experience at any given time. An effort was made to network with a variety of sources in order to have participants with diverse Christian and professional experiences. Peer and member checking was utilized, as suggested in the section on data analysis, throughout the stages of the research. This ensured that the researcher was carefully representing the data and that the final presentation reflected the lived experience accurately. Investigator Triangulation Two peer examiners reviewed the process and final analysis. Peer examiner one is a practicing Sikh who is a grad student. She is an experienced counsellor, and has a counsellor supervision designation. Peer examiner two is a practicing Christian and has a Masters of Education in Counselling Psychology. She currently practices as a school counsellor and has a private practice. Reviewer One was involved in reading two randomly selected transcripts in order to extract significant statements. These were compared with the significant statements chosen by the researcher. Reviewer Two was involved in confirming the meaning units derived from the significant statements. Each of the peer reviewers examined two fully transcribed interviews and compared the interviews with the themes. They both found the themes connected to and captured the experience of the participants. Although they saw the experience of the participants as 61 complex they could see that the themes substantiated the experience. Because the reviewers had the titles of the themes only, there was some confusion in the title of 'Difference'. After discussion with reviewers and participants this was changed to 'Mystery and Difference'. Reviewer One found the revealing themes most resonated with her experience. She found the integrating themes less anchored in the transcripts as there seemed to be snippets of them scattered throughout the transcripts. Reviewer Two especially related to the themes. She reported that although she had considerable experience that resonated with the themes of the presence of spirituality in counselling, she did not previously have the words or the framework for it. An examination by my supervisor, who also checked the data through to the final product, increased the trustworthiness of the study (Krefting, 1991). 62 CHAPTER TV RESULTS The results chapter will acquaint the reader with the following: demographics and brief profiles of the nine participants in the study, identification and clustering of the common descriptive themes that emerged from the data analysis, and an exhaustive description of the themes and the common story of the participants' experience of the presence of spirituality in counselling. The Participants The nine participants were experienced therapists, who identified as Christians. There were six men and three women who comprised the group of participants. They attended the following Protestant churches: Anglican, Baptist, Community, Evangelical Free, Mennonite, and Reform. The racial makeup of the group was Caucasian. The participants were all formally educated in counselling from recognized academic universities. There were 6 participants trained at the PHD level, and 3 participants at the Masters level. All participants lived in the lower mainland of British Columbia. The group had a total of 138 years of experience combined with a mean of 15.3 years experience. Two participants counselled out of a centre that was described as a Christian counselling centre. At the same time, these participants also counselled in settings that were secular. The others were involved in private practice and secular community agency practice. Counselling orientations were varied and were described as psychoanalytic, cognitive behavioural, experiential and narrative, family systems and eclectic. According to the order of the interviews, a brief introduction of each participant follows. The names have been changed to pseudonyms in order to maintain confidentiality. 63 "Aaron" received a Masters in clinical psychology in 1977 and at that time began counselling. He received his PHD in 1980 and became a registered psychologist. He currently practices at a Christian counselling centre and in private practice. His counselling orientation is psychoanalytic. He became a Christian as an adult and currently identifies himself as a practicing Christian. "Brittany" is a PHD registered psychologist. She received her MA. in 1984 and has been practicing for 17 years. She has a private practice and also works in schools. Additionally, she teaches counselling classes. Her counselling orientation is existential phenomenological. She began to identify herself as a Christian as an adult. "Cara" received an MA in counselling psychology in 1994. She has been practicing in the field of counselling for 10 years. She works in the field of drug and alcohol in a community agency and also has a private practice. Her counselling orientation is eclectic. She has been a Christian since she was a child and identifies herself as a practicing Christian now. "David" received an MA in counselling psychology in 1989. He received a BA in psychology in 1986. He has been practicing in the area of counselling for 12 years. He has practiced in the field of drug and alcohol in a community secular agency as well as a private practice. He has an experiential, narrative, solution focussed orientation. He has identified himself as a Christian since he was a child. "Esther" is a PHD registered psychologist. She was trained at the PHD level in 1983 and worked in a government agency for approximately 3 years. She began to practice in a Christian counselling centre part time in 1989 and began a private practice in 1996. Her counselling orientation is eclectic. She grew up in a Christian home and identifies herself as a practicing Christian as an adult. 64 "Fraser" is a PHD registered psychologist. Fraser received a Masters of Education in Counselling Psychology in 1981 and practiced as a school counsellor for 10 years. He received his PHD in 1990 and became a registered psychologist and has been practicing for 11 years in private practice. His counselling orientation is cognitive behaviourist. He grew up in a Christian family and went to church as a child. He identifies himself as a practicing Christian. "Gerald" is a PHD registered psychologist. Gerald has received a BA in psychology, a Masters in Divinity and a Masters in Education. He received his PHD in psychology in 1995 and became a registered psychologist. He has been practicing in private practice for 15 years and teaches counselling related courses. His counselling orientation is eclectic. He identifies himself as a practicing Christian. "Howard" is a PHD registered psychologist. He received a Masters in counselling psychology in 1991 and began to practice at that time. He received his PHD in counselling psychology in 1998. His identifies with ego analytic theories and practices in an eclectic manner. He teaches counselling related courses and has a private practice. He identifies himself as a practicing Christian. "Isaiah" received an MSW in clinical social work in 1986. Since that time he has always practiced in secular community agencies with a focus on family counselling. He identifies himself as a practicing Christian. The Themes The following themes emerged from the data through hearing the lived experience of participants in a taped interview. The interview was then transcribed. The significant statements were transformed into meaning units. The meaning units were then clustered into themes and an exhaustive description was formulated. The result was the following 65 exhaustive description of themes and the common story of the participants. These twenty-three themes emerged as common themes for participants in the data analysis. Not all themes were equally salient to the participants as they revealed the story of the presence of spirituality in counselling for them. Some were more articulate about one aspect over another. The salience of the themes for participants are indicated in the list of themes below. Clusters of Themes The twenty-three themes that arose from the data were framed into four sections and titled. The framework emerged naturally as the themes were clustered. The themes were organized by fit and for ease of understanding. They are not organized to suggest a linear experience, as all of the sections are part of the overall journey the therapists are on, and appear to be recursive rather then linear. The themes are grouped as follows. The first title of integration includes themes 1-2. Themes 3-8 are grouped under facilitation themes in the presence of spirituality and counselling. The third section includes the themes from 9-20 and reveals the descriptions of the presence of spirituality in counselling. The final themes from 21-23 include the reflection experience of the presence of spirituality in counselling. The themes in their sections are as follows: Integrating Themes of Psychology and Spirituality in the Presence of Spirituality in Counselling 1. The Integration of Spirituality in the Training Process - articulated by 8 participants 2. The Integration of Spirituality in the Counselling Process- articulated by 9 participants Facilitating Themes of the Presence of Spirituality in Counselling 3. Therapist's Predisposing Framework- articulated by 9 participants 4. Client's Predisposing Framework - articulated by 9 participants 5. Therapist's Personal Spiritual Journey - articulated by 9 participants 6. Therapist's Sense of Calling - articulated by 5 participants 7. Spiritual Themes - articulated by 9 participants 8. Spiritual Processes - articulated by 9 participants Revealing Themes of the Presence of Spirituality in Counselling 9. Mystery and Difference - articulated by 6 participants 10. Connection - articulated by 9 participants 11. Depth of Meaning - articulated by 7 participants 12. Intensity of Emotional Experience - articulated by 8 participants 13. Focussed Intensity - articulated by 6 participants 14. Sense of Finiteness - articulated by 8 participants 15. Dependence on God - articulated by 6 participants 16. Sense of Self Transcendence - articulated by 8 participants 17. Felt Transcendent Presence/ Intervention - articulated by 8 participants 18. Sense of Enlivenment -articulated by 7 participants 19. Hope - articulated by 8 participants 20. Relinquishment and Transformation - articulated by 8 participants Reflective Themes of the Presence of Spirituality in Counselling 21. Personal Participation in Greater Purpose - articulated by 8 participants 22. Personal Significance - articulated by 7 participants 23. Professional Highlight - articulated by 8 participants 67 The Exhaustive Description of Themes Integrating Themes of Psychology and Spirituality in the Presence of Spirituality in Counselling The lived experience of the presence of spirituality in counselling occurred within the context of the participant's integration of spirituality and psychology. For each of the participants, faith is integral to who they are, and spirituality is part of what they bring of themselves into the counselling room. Therefore, integration is an important component of what they needed to do and continue to need to do in the practice of spirituality within counselling. All participants are represented in this set of themes. One third of the participants regarded the theme of integration as such a salient part of their lived experience in counselling, that they were unable to unfold their story until they articulated their challenges regarding integration in training and in practice. For others, integration was interwoven within their story of the presence of spirituality in counselling. 1. The Integration of Spirituality in the Training Process The lived experience of the process of integration in training was evidenced in the stories of the participants. Some participants reported trying to meet the challenge of a curriculum where issues related to spirituality were not explored, and psychological theories that ignored spirituality and faith as an important human dimension, were learned. The events of training were very fresh and meaningful in the participants' minds, despite the passing of time. "I don't think I ever learned anything in counselling psychology that was about what to do with somebody who feels really guilty about some of the ways in which their behaviours effected other people" Cara reported. She goes on with "it seems like they 68 [her training institution] are still locked in to those issues [racism, sexism and homophobia] and maybe they need to realize how limiting that is and how they need to expand beyond that if they are really to prepare us for the things we need in counselling". Gerald describes missing the area of truth telling in his training. Currently, he sees the practice of counselling in the light of truth with ourselves, and others, and the meeting of an objective and subjective truth. He stated, "There's something else going on about the whole truth telling. I'm not trying to start my own school of psychology but that's something that I would say when I was a student learning -1 really didn't go into that". Brittany talks about her personal struggle to integrate while in training, "So while I continued to study and do my PHD and work in a secular context, I wasn't benefiting, I wasn't developing spiritually in a professional way. I was developing other ways in a professional way, then I would sort of wrestle with spirituality on my own." One participant reported with delight an opportunity he had during his training in a week long intensive course where his Christianity was challenged in an intimate group of students, "I had to do a lot of processing within myself and "so I was challenged by these fellow students. And I think through that process, I transformed. And became a much stronger, more stable and secure Christian in my faith. So I think that that of course, also has helped me in my work". Fraser went on to describe how much it had meant to him to have the opportunity to write a paper in this class that also incorporated his faith and have that accepted. . Other participants reported challenges between the material of the training and their faith, "it was around this time in grad school where I really started to feel conflicted between this sort of secular, humanistic psychology stuff and my Christianity" (Cara). 69 Aaron reports his integration, I think when I was in grad school, I saw my psychological understanding as in opposition to my Christian understanding. I think somehow over the years I have come to integrate that more, so that my emotional functioning and my emotional therapeutic role with the client isn't necessarily in opposition to God's work. It is very much an avenue by which God works. For some, feelings of incompleteness in training were joined by feelings of prejudice against their faith that were wounding and needed to be worked through. There was a feeling that their personal experience of faith had no voice in their training. Brittany tells her process of integration. "I think it has been a struggle to identify as a Christian, because out there in the psychological world [of training], Christians are bashed a lot, and so for me I would often remain silent about my Christian beliefs." And Brittany goes on to say, "I don't have that stigma [of Christian bashing in training] anymore, so I think because I'm not carrying that around it makes it better for me. Wherever I am, I know that now I can work in any capacity and I'm okay". And later, "Finally I'm at the point where I can say - this is more integrated for me - this is more congruent". Cara describes her rejection. I was scared to say anything [in training] or sometimes I would start to say something and then I would get these looks from people around the table - either hostile looks - like assuming looks - you just know they are thinking I am some kind of right wing fanatic or something or thinking that you're some kind of traitor in their midst. 70 The lack of voice for spirituality in training and the personal wounding of faith have been worked out in Brittany by providing a voice for others who have been spiritually wounded. Training in a field that has few models that incorporate spirituality, participants have turned to spiritual models to understand their spirituality and its relationship to counselling. Isaiah comments on the way he has thought about the suffering he sees before him. "I guess I connect with people like Jean Vanier, the L'Arch communities, Henri Nouwen's work and people like that, who have helped us articulate that being human is about accepting our brokenness and we don't do that without suffering". In talking about the place of his own sense of spirituality with clients, Gerald reports, "Probably the greatest living monastic person of the century was Thomas Merton, I would think. And he said at the end of all his journeys - of all his spiritual disciplines, that the result of all of that is, that you become incredibly ordinary". He also uses the model of Mother Theresa where she would get up at 5:00 a.m. and pray (described as doing her work) until 8:00 a.m., before she began to live the day. Gerald describes that way of being as "her care for people flowed out of her spirituality and I sense that with my care - there is no care if there is no spirituality". Others infused the psychological theories that they had learned with spirituality in their process of integration. Aaron says, Winnifred Bion speaks of the container and the contained and Donald Winnikoff speaks of an emotional holding and I think for me there is a powerful sense in which there is an emotional holding going on - an emotionally holding of the client but somehow there is an emotional holding from God in all of that. 71 Brittany described it this way, "I like the Satir model so much because Satir talks about hope and I could then take that hope and translate it into my own spiritual terms, so that made it something more salient for me". Although the presence of spirituality is difficult to articulate, there was also some evidence that the lack of training in spirituality Compounded those difficulties. It is in training that professionals learn the language of their profession. However, the language of spirituality in psychology was not learned. The challenges in articulation were reported by 7 of the 9 participants. When trying to relate spiritual functioning and emotional functioning Aaron struggles to articulate, "I am not so sure using a metaphor -interwoven - isn't necessarily accurate because it implies that both bring something different and it may just be simply perspectives of the same kind of experience... So I am not sure I even have that worked out to know how to address that." David struggles, "having a client respond to that sensitivity in a way that opens their spiritual experience -I'm trying to use other words - to try to talk about it in another way, other than sort of spiritual words." 2. The Integration of Spirituality in the Counselling Process In their stories, participants reported how they faced the challenges of merging their psychological processes with the spiritual processes in their client practice. Isaiah describes the limitations he feels in his place of work. He says, I am very aware of working in a secular agency -that I stop myself from engaging in that conversation about my personal religious beliefs and about their personal religious beliefs, and I wish there was more freedom to do that. I think there could be, but it would require a great deal more tolerance by general society that value-based work is legitimate and okay even in a secular place. And he wonders how he might be different if his practice restrictions were different, I have sometimes thought what I would do with that if I didn't work in a secular agency, I think that is another factor in what I do with my spirituality in my work. I have never worked privately.. .1 may engage in some of that exploration together. I know I would want to be just as respectful of them and their process of working through their faith and their understanding of truth and how they want to live, but I might be more explicit about the dialogue. David struggles with the practice area of accountability and goals he must set with his clients as a measure of accountability. He sees this practice devoid of spirituality. He expresses his frustration of working within this system as he reports, I personally feel that when a person has a goal and it's clear and it's concise and it's doable and it's measurable and it's time framed - that's one level. That's one level of thinking - and it is thinking. It's not even thinking and feeling often or it may be but it sure doesn't look like that on a page so that doesn't feel very spiritual at all. So yeah, singular experience in a thought mode - probably emotional mode, • singular experience doesn't feel very spiritual to me. There is also tension described by some participants between their faith and their practice. David expresses, There's a little bit of tension because there's a tension between the ethics of our profession and the worldview of being a Christian. Where we're all going. What eternity means. Yeah, so there is a tension there and sometimes I have wished that I could just put up a flag and say I am a Christian counsellor (yelling this and laughing) and if you come to me I'm gonna - I'm going to act completely Christian. 73 Cara also experiences tension regarding her Christian experience, and the ethics of counselling. She says, We were exploring the 12 steps along the lines of -1 don't really make suggestions for a higher power - this is hard sometimes - I almost would like to do a commercial for Christ (laughter) but for the sake of your own integrity as a counsellor you let clients choose their own path. Isaiah talks about the limitations he experiences regarding spirituality as a loss. He says, "I think it [not being able to fully express spirituality in practice] is a loss though. Maybe one day I'll have opportunity somewhere where I can more directly express who I am spiritually". Participants reported many ways in which they had integrated psychological processes and spirituality in their practice. Aaron describes how he uses psychoanalytic processes such as transference and counter-transference in an integrated way. He says, "I guess I see a lot of the psychoanalytic things that I have always understood and tried to use as being more tools, in a spiritual direction, or spirituality, than issues that are isolated from one's spiritual experience or spirituality." He goes on to say, "I am feeling more and more, especially as I get older and in this profession more, that I think more about creation and that if I'm working in understanding my client through my own reactions, then that's part of God's creation and that's a very appropriate tool." Esther describes using EMDR with abused Christian women, With some clients, I have come to the conclusion that it [EMDR] works very well, but with some clients, they come to a plateau there and unless they really experience Jesus coming into the situation with them, they are not going to get any-74 I mean - usually the disturbance goes down -the disturbance goes down quite a bit, but for some it is not going to go away. Howard uses visualization and incorporates God in the form of a sense of peace or the actual person of God, "And I gave her some visualization about - about God coming down to kind of relieve her." Esther has her clients journal and says, "Most of my clients will bring a journal in and I also encourage them very much to be aware of their dreams and we look at those as well. So then there is a lot usually that they bring that we can talk about that is related to [spirituality]." Howard also uses joumalling as a way to integrate spirituality into therapy and to find a "truth bigger then our reasoning". He states, "I ask lots of people to journal. And when they journal I ask them not to write too much of their thinking but more of their feelings and intuitions". Cara talks about how she uses psychological techniques with children in an integrated way, "Even if it is not discussed I think I kind of get there in a non verbal way often. Like with children I tend to do a lot of art and play techniques that I flunk have a spiritual component in them". Fraser uses cognitive behavioural process and integrates spirituality, I guess one of them that sticks in my mind is a woman who is a wife, a mother who struggles with some negative thinking about God. And struggling with the unpardonable sin. And so we are doing a lot of cognitive work at this time because she seems to have planted some thoughts in her mind about the unpardonable sin some thoughts she has had about God. Cara tells the story of her work where she has the opportunity to use the 12 steps as an integrating practice for her spirituality and psychology. 75 She says, I've been working with alcohol and drug addicted people, many of whom are working the 12 step program which is entirely about God and a higher power and turning over your will and so I've been able to sort of go back to a lot of my Christian roots with of course a renewed perspective with all this - all the good stuff of the secular humanists and humanistic psychology thrown in and I've been able to - its almost like there's this bridging between psychology and Christianity. For some of the participants there is a change in the overall field of psychology that enhances their integration. Brittany, who sees the area of spirituality and psychology as more acceptable in practice states, "It's [spirituality] something I tend to be more comfortable discussing and of course now its more encouraged." Howard reveals optimism when he expresses, But I think it's wonderful that we are finally [we get to talk about spirituality in psychology] exactly and that we are accepting people's experience and descriptions of it and it really is a phenomena of post modernism, I guess, but isn't that a great evolution - not only in our approach, but in our understanding of people. Facilitating Themes of the Presence of Spirituality in Counselling The following themes are described as facilitating themes for the presence of spirituality in counselling. These themes are: Therapist's Predisposing Framework, Chant's Predisposing Framework, Therapist's Personal Spiritual Journey, Therapist's Sense of Calling, Spiritual Themes and Spiritual Processes. These themes are important to the lived experience of the presence of spirituality as they provide the context to the felt presence of spirituality in sessions. 76 3. Therapist's Predisposing Framework As part of the story of the presence of spirituality in counselling, the therapist's framework provided facilitation in the form of their framework of beliefs about people and spirituality. One salient part of participants' framework was to see all people as spiritual and to see them on a spiritual journey. David says, "it is my belief that every person, Christian or non, is walking some kind of spiritual life". Brittany sees all adults and children as having a sense of spirituality. Brittany goes on to say, I thinks there's a soul in everyone whatever language you want to call that as and there's still that seeking for - for how do we make sense of this world and who's in control and how - why does this happen, and why does this happen to me, that to me sort of encompasses that the notion spirituality -1 think for some people its very poorly defined because of their own life experiences and what they're able to -what's happened to them, what they're able to make sense of -for other people its more defined and -and some people are more able to voice that. Although descriptions of spirituality were challenging to articulate throughout the study, the participants described their sense of spirituality as part of the whole, not separated into compartments. Howard describes his framework this way, I don't perceive human experience as being separated into spiritual, the physical, the emotional, the soul cause that's sort of dualism or trialism or whatever you call it - it is something that has effected the Christian faith for a lot of years and has done a real disservice.. .its just part of everything and so I am spirit -1 am body -1 am soul. It is not -1 have a body, soul and spirit. 77 Esther put it this way, "I mean it all relates together. It is really difficult to separate in any way [the psychological, emotional and cognitive, spiritual]." Gerald used the analogy of a flashlight to describe spirituality in himself and his clients. He says, I don't see my spirituality as a separate part of who I am. Its all part of me. I would say that its like a dark field at night and you go through it with a flashlight and what you're seeing - sometimes you kind of see - you flash on - you're more aware of the spiritual part of you [or] you're more aware of the cognitive part of you [or] you're more aware of the emotional part of you. And Aaron described the way he sees the area of spirituality and himself as a therapist working, More and more lam getting a sense that I bring my whole person in here; body, soul and spirit, so to speak. My whole person is meant to connect with the whole person of the client, so I can't leave my spirituality out even if I wanted to, but I can't bring it in some kind of arbitrarily prepackaged form either. If it is not part of who I am, then it is going to ring artificial and it is not going to be terribly productive. So I feel that I am much more comfortable being my whole person, and whatever part of spirituality is there, is there, and whatever part is not, is not. I feel much more comfortable with just being who I am in all phases of that, and being open with that same kind of wholeness with the client. I know it doesn't help in term of nailing down what spirituality is, but I have really come to see that unless it is in here [pointing to heart] there is not much use and it becomes a technique or a tool and it loses the high value of connectedness with the person you are trying to be with. 78 Part of the therapists' framework involves belief in a personal God who is connected to the process and the people whom they deal with. This is central to them and provides a foundation to their work. Isaiah talks about this as " a kind of presupposed framework for me that there is a personal God who is interested in this creation and I understand that connection to be there in my work". He goes on to say, I try to remember that that [spirituality] is the centre of my work always, no matter what the experience is that is going on between me and the client, and that is not always conscious and that is not always active in a sense, but that is where I try to situate myself, is within that kind of a framework. Howard explains how his faith is embraced in his counselling this way, My worldview is still there. My faith and my understanding of God - not that I have it all structured and put together and it changes and evolves, but anyway, my commitment to it is still there and it pervades this but it doesn't mean I have to persuade and it doesn't mean I have to explain it [to the clients]. It just undergirds it." While telling their story, participants illustrated ways they had connections with their faith and how that impacted their counselling. For instance, Howard describes using the symbols of the transcendent intervening with humanity, with a client, "And in my mind it was probably because her shoes had come off and I connected this to the story of Moses in the Old Testament when the burning bush was presented to him". The participants have frameworks that impact the way they see the dysfunction and pain that people bring to therapy in light of spirituality. Aaron describes that part of the human journey in this way. 79 Aaron says, So I think a lot more in terms of creation - who is this person that they've created and I see pathology as more in terms of a deviation of development so if we can -we get the pathology more straightened up then this creation can develop in the way it's meant to be. I think creation a lot and I think pathology a lot but I don't think dramatic redemptive stuff very much. I think more of progression of creation rather than some divine [zap] that comes in and changes it all. Fraser talks about the brokenness in his clients and how he sees that relationship to spirituality in his counselling. "This is the essence of what I want to get at because that (the emotional/spiritual part) is where the brokenness comes from. And so when I help my clients on their healing journey, we basically want to bring about wholeness in the brokenness that has been part of their lives." Another manifestation of this theme was the participants' beliefs about the pain that their clients were suffering and the direct relationship of suffering to spirituality. Isaiah likened the value of suffering in a spiritual context to a phrase from a Leonard Cohen song, "There is a crack in everything, that is how the light gets in". He goes on to say, Learning to accept it [suffering], learning the lessons from it, is going to make them more in touch with their deeper humanity. That is my presupposition going into it, and that is what I hope to get them to accept, that that is going to be part of their learning in life, and it will lead them to a bigger view of life in the end. Participants talk about their bias towards the growth of spirituality for people. 80 Isaiah remarks, I would hope that that would be something that would lead them to a bigger and better understanding of life, capital L, and perhaps a more openness to God in their own life at some point in the future. That's my bias, that if we are connected to God, we are going to be living life more with the purpose that it was meant - that is my bias about creation and how we are to live. Howard reveals his framework regarding the relationship of the transcendent and his clients. To me - my goal as a counsellor is partly to help people get in touch with the transcendent, but that doesn't mean they will exactly the way I do. Although I do have this hope underlying it that they will discover truth that is redeeming and that is meaningful and vibrant and transforming for them. And Cara reports, "Ultimately, He [God] is the healer and that if something wonderful happens for my client I need to acknowledge that somehow". There is a sense of trust in that belief. As Esther recounts, "trusting is very important too. That God has started something in this person and He is going to continue even if the person never comes to see me again." Participants talked about their desire to model their counselling relationships after their understanding of God in relationship. Esther describes it this way, "I think that we always have to look at Jesus - how was He going about when meeting people, [so the compassion] ya and He tried to meet them where they were at and listen and then help them" and then later in her story, "and I am waiting. It just reminds me of God, how patient he is with us." Howard affirmed the meaning that a spiritual framework has for him. 81 I understand that my interpretation and my perspective is very much encrusted with my meaning - the way I perceive spirituality, but that doesn't make it any less valid just because somebody takes it differently. 4. Client's Predisposing Framework The client's predisposing framework was a theme that impacted the salience of the presence of spirituality in session for the therapist. Therapists talked about the importance of respect for clients' own frameworks around the area of spirituality and the sensitivity that the therapist needs when entering this domain in therapy. Therapists seemed to be aware of their own frameworks which allowed them to enter a place of unknowing concerning their clients frameworks. Isaiah reports, "Whether the person is.. .of a different spirituality than me or of no spirituality.. .1 want to hope and connect with them around their journey for truth". David describes how they presence of spirituality becomes a part of the session through a client's framework, "Sometimes, just because they talk about it [spirituality], that gives me permission to talk about it." Aaron talks about the connecting that is there for his clients when the presence of spirituality is prominent. He says, Christians are the biggest population that I deal with - when faith for them is an integral part of the client's life, such that anything that happens in their life, or any experience that they have is almost automatically connected with their relationship with God - that doesn't necessarily mean that God did that, but that somehow everything that happens in life is somehow brought under the understanding of God and the relationship with God. I think when something powerful happens in a therapy session, that sense is there too. 82 Commenting on the openness to the presence of spirituality and cultural differences in that, Esther describes her experience, "For some people - 1 mean they know their lives have a spiritual component, I mean if they are Natives, they are very much aware of it. A European background, not very much so or nothing at times". Or as Cara remarks of the sensitivity to spirituality of a First Nations client, "Even though she didn't practice any particular kind of native spirituality - she seems to embody the traditions of it". Participants' stories included times when spirituality was present as part of a client's goals, "The client was trying to embrace some kind of spirituality in her life. We talked a lot about what faith means." Aaron goes on to say what it is like when there is no sense of spirituality with the client. He says, I honestly feel the difference when I sense that they don't experience this as something under God. I feel like the experience somehow, whatever degree that's real, good and powerful and impacting, the experience is still missing that element... I don't want to make it sound incomplete, but it is not as full because that dimension isn't there... I feel the power of what they are going through, but I also feel a little bit of sadness, because this isn't something that they can integrate into a life of faith. Fraser finds, in dealing with someone who does not attend to their spirituality, But the same power does not seem to be there, because I am not receiving the same kind of responses from the client. So I look at my client as a child of God, who has chosen not to be part of God's world and God's covenant. I still look at that person that way, but that person does not necessarily respond that way, and doesn't feel that way, so I get a bit of a difference there. 83 When clients share a framework of spirituality, there is a feeling of connection around shared values and possibly an ease to go deeper in therapy. Isaiah says, The situations that I am thinking of, the other people were Christians and there was a lot of shared values and beliefs that probably - and they knew that I shared their values and beliefs so I think that that was an easy connection for us to make and I think easier for them to accept that this was a gift from God that they could then take to a deeper place for themselves perhaps. Brittany describes ways there is a connection with language that paves the way for the experience of spirituality in session. She says, We might be able to share the language a little bit easier - like I saw a client just before you came and so we are able to talk about evil which is part of spirituality and use those words and understand each other because we both were coming from a Christian perspective. Cara describes her connection with a Buddhist client over shared spiritual ideals, But around that time he was getting into Buddhism and so he was getting into exploring some of the ideas of Buddhism around self denial, and transcending your own needs, that kind of stuff and so as a Christian I was able to - you know a lot of -so called Buddhist ideas of transcending your own needs and self denial are also in a lot of Christian ideas, turning your will over to God - much of the Buddhists would let go of their desires or will so there were just some moments with him where - 1 wasn't discussing my faith with him at all, but we both just looked each other in the eye and its like I understood him and he understood me, even though we were both coming from completely different spiritual directions and there was this sort of - these uniting spiritual principles. 84 Gerald describes differences in clients' spiritual sensitivities in the context of the presence of spirituality in session. He says, I could see somebody just thinking that's wacko [the presence of spirituality] and being shut down so I think it's a matter of spiritual sensitivity.. .1 think its like some people are much more in touch with their emotions readily and others are out of touch and its because they've shut themselves off from that or they are not just quite as emotional - there is a breadth of emotional expression - and I think that's kind of the same for spirituality - that there's people who by nature are kind of spiritually predisposed .. .[and] they tend to be more other worldly minded - very concerned about meaning and reality. Additionally, participants described clients' frameworks where the issue of spirituality was a challenge. Esther shared an experience where a man was "abusing what he saw - that he was such a spiritual person. He was abusing that tremendously". It was a difficult couple experience to deal with as Esther had "feelings for this poor woman in therapy". Gerald gave an example of working with a person with multiple personality disorder, "the alter that came out was malevolent and evil. Profoundly evil.. .it felt profound real, intensely spiritual". Aaron and Gerald also talked about spirituality as a defense with people who come to therapy with issues of spirituality. Gerald describes his challenge with a New Age client and his Christian clients, I would say her spirituality is her defense - which I would say it is for a lot of Christians too - not just nonChristians. But it is her defense mechanism - she hides behind it a lot and it doesn't lead to - I'm not sure it leads to greater authenticity. I think it leads to a forgery of authenticity. 85 Sometimes there are challenges with spiritual wounding in the clients' past and the presence of spirituality in session. Esther says, "Often you then find out, oh, there were some hurtful experiences in the past concerning their religion in their lives, so then gradually, I might be getting them to deal with those issues if they are open enough." Both Brittany and Esther work with abused clients and Esther remarks, I mean with some clients, it is really a struggle. Especially if they got abused in a church by a pastor, and then gradually seeing that there is a difference between God and who He really is, and this pastor, who has no respect, or for some it is the same as their dad. 5. Therapist's Personal Spiritual Journey Another theme that is part of the story of the presence of spirituality in counselling is the impact of the therapist's own spiritual journey and their sense of being in touch with their spiritual self in counselling. Participants in the study took their own spirituality seriously, in relation to their counselling. "The therapist has to be struggling to be whole, because that's real, and as you do then spirituality in whatever way you define it, has got to be there because it is part of the counselling" (Aaron). Therapists reported times when they were "more thoughtful of and mindful and present to God being in my life and being in my work" (Isaiah) and they noticed they may ask more questions around the area of spirituality including, What they [clients] are doing in terms of keeping themselves connected to a bigger picture in life, and a more profound creative process in their life, and more in touch with nature and things that are a little deeper and beyond the mundane that they 86 feel stuck in. I probably would engage in these conversations more easily when I am feeling more like that myself (Isaiah). Aaron talks about the importance of the integration of spirituality into his own life in order to bring it into the counselling room, Unless I have that sense of spirituality integrated into who I am, I am not going to recognize it as how it is integrated into who they are. Otherwise it becomes an artificial distinction - my faith and me - as if they are two different things and I know in my own spiritual pilgrimage, when I feel like that its integrated, and I don't have all the questions answered, but if I feel it is integrated in who I am, and it's real, then I hear it better in my clients; what place it has in their life and again I think the I- thou relationship is what makes spirituality happen or become alive in a relationship in the therapy room. Gerald and others recounted times when the presence of spirituality in counselling was present for them even when they felt distant from God. Gerald describes the year of his doctorate and the following 3 or 4 years as some of the most distant he had ever felt from God. "And yet I have given you at least 3 highlights from that time frame... and again that is really congruent - my lived experience is really congruent with my faith experience in that sense, that I would just say that's grace". Brittany talks about her personal struggles with spirituality as helpful when sitting with a client who also struggles, And I think as much as I dislike all the [spiritual] struggling it helps so much to know - to have experienced the struggle so that when you have a client sitting there and talking about their own struggle then I'm better able to relate to that not that I'm going to disclose all about my struggle but then I am more able to listen, 87 I'm more able to ask questions or comment or reflect in a way that's more meaningful to my client. David talks about how his spiritual disciplines affect spirituality in counselling. He reports, I think there are times when I'm learning something specific in my own personal time with God that applies to what is going on in the counselling session and I would mention it -1 wouldn't mention it in Biblical terms or anything -1 would mention the principle - how I've been inspired. In describing how her spiritual journey affects her counselling, Brittany says, "I'm more loving than I used to be and I think that's because I'm more grounded in my own spirituality. I feel like I can be that notion of being Christ like. I think I can be more that way because I'm more aware of my own spiritual identity." David's personal journey and his experience of God's compassion for him impacts his counselling. "And so I have personally experienced God's compassion towards me and so how can I not give it to someone else? Sort of a natural process". In trying to be more Christ like in his counselling, Fraser talks about shaking "off any of my own stereotypes and my own judgements... And I think that doing that helps me to become a more effective counsellor because I immediately become very open and accepting of the person who sits in front of me". Cara says of her struggles in being with clients and her own sense of spirituality, "By being a child of God and praying that he is writing his laws on my heart - maybe things I'm not even aware of - that's my hope - that the principle at least of Christ may be present in my ability to be with clients - to live justly but to love mercy". Aaron relates how he has a "huge appreciation for grace in so many ways" in dealing with humanity, his own and his clients. He remarks, "I think having gone through psychoanalysis, it seemed on the depths of my own sinfulness, my own issues, that certainly comes into play". Therapists' stories included their struggles with the stress and spiritual burnout from the job and the necessity to process the pain that their clients brought to session. Gerald remarked, When you do not nurture and guard your own spirituality - when you don't guard your care - when you don't guard that sensitive part of who you are - you will become cynical and bitter.. .And the worst kind of care is when you don't have any to give. And you give it - you give it out of a drive to do it - cause that really damages your soul. You become very resentful and you become professional where you begin to remove who you are from what you do and there is a separation within. I have been to the place where giving care from a professional place where I couldn't be there as a person and that's a spiritual issue. David talked about his experience " I lost touch with what it all means, who I am, what am I doing this for- some of the meaning questions - 1 kind of lost a grip on those" and David continued, "I'm quite sure I was not nearly as willing to go into deeply traumatic stuff with my client when I was feeling that way. It was just too much for me. So I am sure I must have kept the sessions a little shallower." Therapists' own woundedness in the area of spirituality is reflected when they tell their stories. When they talked about the presence of spirituality in a session, some participants were sensitive and reticent to be specific about what was coming from God and were more comfortable in describing things as feeling "beyond them". As Gerald said, "I'm uncomfortable - very uncomfortable with saying, "thus saith" - no I'm not very uncomfortable -I am off the wall uncomfortable with saying, "thus saith the Lord" 89 kind of thing - Really uncomfortable with that because I have suffered incredible abuse with that kind of stuff. Cara talks about her experience, I'm very reluctant because in my background people would say well, God told me to tell you this - I'm very reluctant to be one of those people that thinks - you know- that I'm being God's little soldier doing this or doing that in any one moment but I like to think that overall are some things there that happened in that time that I worked with that fellow [where God was present]. And Cara further describes her challenges in being cautious about where God is present and where he is not, I think a lot of my trepidation comes from my not wanting to do that, but then I don't know whether being cautious is sometimes limiting - you can't ride a bike if you ride it too cautiously or too slowly - you tip over, and lots of times you need to just peddle away and I guess that's what I'm trying to do by not worrying about it too much ,in terms of whether I'm experiencing God enough or right or whatever -I'm just trying to live my life and have some ego strength, because you can't have any ego strength if you're living in doubt all the time, and just to hope that if I've got it wrong that God forgives me. Fraser suggests, "I think the only way I can survive as a counsellor who is a Christian in this field is to be very constant in my faith life." The participants also share how nurturing their own spirituality through their spiritual community is so important to their own spiritual health. Cara suggests her community plus like minded friends "supports my spirituality" and that having those alongside her job is very important to her. Aaron considers his spiritual community vital to his counselling and suggests 90 For me.. .it is very important to worship on Sunday because I feel like when I am really well connected and worship in a corporate body, I feel like it is more a part of me and it is only when it is part of me then it can be part of the relationship so [I see] Sunday worship in particular, as being absolutely vital to my counselling. It helps me to integrate something I can then bring into the therapy room and it is not tools - it is not technique. 6. Therapist's Sense of Calling Within their stories, therapists perceived an understanding of the work of being a therapist, as a sense of calling. Isaiah describes it like this, I have had that sense of vocation about my work, coming from my understanding of God's care for me, and care for the world. This is a way in which I participate vocationally in that enterprise of caring for the world, and so out of that context, is where my work comes from. David describes the sense of calling for him, "In my private practice I have a sense of what God wants to do through me. I have a sense of call there... It's fun and it's very challenging - very challenging to my character." And as Brittany has grown in her own spiritual journey she sees changes in the way she views her work, "I know I'm different than I used to be - 1 think its more like I see my work, even in my school settings, as more ministry than I used to". Gerald talks about his calling as, "I think that it's [calling] something that you sense that you are supposed to do. That you are gifted to do, that you are good at. Psychologists would call that self selecting - same thing. I have a feeling that this is what I'm here for. 91 7. Spiritual Themes Participants told the story of how the context of spiritual themes, such as the experiential struggle with spirituality, spiritual development, forgiveness, reliquishment, grace and humility facilitated the presence of spirituality in therapy. Although David works in a secular agency, he finds that it is meaningful to bring up the area of spirituality directly in assessment. He says, "I'm glad that we have on our assessment form, a section that asks about the clients' spirituality. I like to ask that question and I take a few minutes with the client to explore what that means". Both Isaiah and Gerald talk about helping clients find their own truth in the area of spirituality. Gerald remarks, "which isn't always what you are comfortable with as a predisposed Christian." Clients themselves may bring up spirituality as a theme in their lives. Aaron reports, Clients at some point would come to some kind of "what does all this mean in my spiritual life too". Stuff I'm wrestling with in terms of my own family, in terms of my own person, which could also be in terms of my own relationship with God. And those are always not just important times, those are often times very significant times in the life of a client, and even in the life of the relationship together. Fraser talks about the issues of spiritual development as a time when the presence of spirituality is felt in counselling, "Well I think that when we are on a topic of spiritual development and bringing about some wholeness where there is brokenness, I feel a little bit of the presence of the Spirit there, to guide the process." Aaron talks about being most aware of spirituality in session when he feels "the client is really struggling with some spiritual issue in their own life, and particularly in their relation to God". 92 Participants found that certain themes such as forgiveness, and letting go, facilitated the presence of spirituality in counselling. Howard says, The other thing is when people forgive - and in counselling I think that's a fairly big theme. So when the person lets go and relinquishes resentment or hurt or reads this letter of letting go or makes the statements to this person who really isn't there but anything like that-1 think is a very - I sense a spiritual presence that is bigger than what is typically there. Howard goes on to say, Also because I think anything that has to do with forgiveness is - is about surrender, its about relinquishment and its about spirituality because it means that you aren't going to take this into your hands anymore. You are going to let it be -you're going to let it go and who of us doesn't need to be forgiven? With his Christian clients, Fraser brings the theme of God's forgiveness of the client into the sessions. "I tried to bring into our discussions the whole nature of the fact that we are sinful human beings and that God forgives sin." Fraser also brings up the issue of grace. He goes on to say, "And then bringing into that whole process as well -1 bring the whole issue or concept of grace. And that through Christ's sacrifice on the cross, he has shown us ultimate grace. In that no matter what we do, all our sins are forgiven on an ongoing basis." Esther talks about coming to the end of one's struggle and looking to something beyond oneself as a theme which facilitates spirituality in counselling. "He was realizing that he came to a point that he can't do anything on his own any more. He came to a point that he knew that. He opened himself up that there must be Somebody who can help him...God." 93 Participants also talk about humility and as Cara experiences, "Humility is a big spiritual principle in AA programs and it really helps you to be phenomenological with your clients to go with them and at the same time challenge them, and that's been really rewarding." As well as themes of forgiveness, relinquishment and coming to the end of one's own struggle, themes of abuse, death, loss and the fears surrounding those, were identified as facilitating the presence of spirituality in counselling. Gerald said of working with the theme of abuse, "I seemed to just have a lot of survivors of sexual abuse as children... it was also one of the - probably the most profoundly human journeying I did with my clients. I felt like - I was with most of my clients for a few years -1 walked with them for a few years and those were days what I would consider to be where the spiritual component was really critical." The issue of death and loss facilitates the presence of spirituality in session as described by Brittany, I can think about one incident when I did school counselling a few years ago. There was a little girl that was killed and it was very very sad and it really impacted a particular group of kids in that school and I spent a lot of time providing the ongoing grief support for them and we would talk a lot about, what do you think happened? Where do you think the body is? What do you believe in heaven? .. .But so you know I connected sometimes on that level. Howard spoke of his experience, [themes of death and loss] are always there and I am probably a little bit more -I don't know oriented that way just because of experiencing loss in my own family and so I am just a little bit more keenly connected - you know - and so we have to 94 face our fears of death that we all have and if we can't.. .[we can't really live] well that's right, because I think the fears of death become mirrored in our fears of living, and we fear the unknown and so we don't risk in life or we fear pain and suffering so we don't again deal with things - the disciplines that require us to face our pain and suffering, or that demand us to push ourselves or we fear judgment and so we project on everybody else instead of - anyway all our fears about the after life. 8. Spiritual Processes Participants reported that spiritual processes facilitated the presence of spirituality in sessions. One process that came up in participants' stories was the use of prayer in a session. Esther remarks that for those who are open to it, "for most of my sessions, I start in prayer". It is very much a part of her counselling sessions as she will also use the process of prayer at the end of sessions and during the sessions, if clients request it. Esther goes on to say that with couples "opening up with prayer - often conflicts going on between them, it is great, because it softens their hearts already". Participants have differing ways of using prayer in session. Aaron, in speaking of clients who have a faith perspective, So, for example, do I pray with clients? Yeah I do with some. I don't with others and I know that for a lot they may scratch their head and wonder about that, but for me to pray with a lot of clients ends up being a technique, it ends up being something other than a connection. But there is some that there is a very important connection and prayer is a very appropriate kind of experience to share together with them and for some it is not. 95 So in relation to the presence of spirituality and prayer of other specific spiritual processes, Aaron represents the views of others as he goes on to say, "I can't use models or techniques - that doesn't do it for me. It ends up being a little more ethereal" Howard gives an example of one of his own spiritual processes that accompanies the spiritual in sessions for him. He says, "I was in the spirit of prayer" as he told the story of a particularly salient experience of spirituality in session. Howard talks about using visual arts as well as music, "To me, those are incredible ways to connect with our deep self, as well as something beyond us". He goes on to describe other ways that facilitate the presence of spirituality, Sometimes I'll encourage people to actually participate in something I might call a spiritual practice. So it might be part of their homework. Like to go into nature by themselves for 3 hours and just use their senses and discover what's there and just kind of leave it open. And sometimes they come back with pretty interesting things that have occurred or - or they see something in nature and they talk about it and its just incredible how that becomes a key or an analogy for their own life. Esther uses journalling, as well as other processes with her faith clients, "I usually encourage them greatly to do some journalling, do some writing, to I guess, have their regular times with God and reading in the Bible." She goes on to say about faith clients who are struggling with misbeliefs, And one client often comes in with "Oh God has revealed something else to her" and often it is that they believe a lot of lies about themselves and about the world as such. So then it is extremely important then to also look at God's word... It is not true that I deserve to be miserable or that I deserve to die, whatever a person might believe. 96 Cara talks about the process of the 12 steps as bringing the spiritual into people's lives and counselling, "the process of repentance and atonement that people go through when they work the steps -the whole thing about taking a searching - a fearless moral inventory of your character defects". Esther also uses the process of repentance in her counselling as "an opportunity that I make available to people if they think that there is anything in their lives that they haven't repented of yet, that they can do that now aloud or silently or what ever they prefer." Revealing Themes of the Presence of Spirituality in Counselling This category reflects the themes that were manifested in the stories of participants' experiences of the revealed presence of spirituality in the counselling session. The themes included the experience of mystery and difference, connection, depth of meaning, intensity of emotional experience, focussed intensity, sense of finiteness, dependence on God, sense of self transcendence, felt transcendent presence/ intervention, sense of enlivenment, hope and relinquishment and transformation. 9. Mystery and Difference Participants are challenged when they try to verbalize the presence of spirituality in sessions. One of the themes that comes up often is the uniqueness, sense of mystery or difference in the presence of spirituality when it is particularly salient in the session. Isaiah says, "It was definitely different from other sessions and different from probably other sessions with that particular person, probably too". David says, "there's sometimes the overt discussion of spirituality and other times it's not mentioned at all, and it's the sheer experience that happens in a session that I don't know how else to call it except that it seems spiritual". David tries to articulate this different mysterious presence of spirituality. 97 I will pray silently that whatever is going on -1 don't know what to say there - but for some reason I want to pray and I will bring a sense of spirituality in but it is silent - it is not overt - so that is brought in for me although it may only be a momentary sense and sometimes it - how can I put it? - okay - like the book of Esther. The book of Esther doesn't really mention God. But it's obviously a meaningful spiritual book. So sometimes in sessions there's -1 have a sense that spiritual things are happening.. .something spiritual is happening but there is no mention of God or spirituality. Howard said of his experience, "And I knew something really amazing and remarkable was going on.. .it was very special. And I have no other way to describe that - than it being a spiritual experience...I felt that there was something really - really mysterious and spiritual going on". Both the therapist and the client are feeling the uniqueness and moreness in the enhanced spiritual experiences described. Howards reports, "and then she described - she said this was like a peak experience I've never had before." Gerald describes the experience he had in this way, "That was very atypical - that whole thing of peace is very atypical but I think it does capture (long pause) a sense that there's more to this counselling enterprise than merely applying psychological principles with appropriate techniques." There is also a sense of "bigger than" in this difference. Gerald says, "there is a portion of the time where I feel like something is going on here and I'm working with something bigger than me." Howard talks about it as mysterious, There are times that I feel emotions that just seem bigger then me and that also puzzle me a little bit because I am not sure why I am feeling so strongly or so 98 passionately. Because I mean, I think counselors that are genuine and authentic and hopefully have some caring and respect for people will feel with them. But I am talking about times when I am feeling with them to a greater degree and its hard to explain - that's another reason why. I can explain other times - you know -1 have experienced this so I can understand and I would feel with them or whatever -1 can explain that but there are times when I really can't explain and I think that's where it becomes elevated to something that's more transcendent. 10. Connection Connection is manifest in a number of ways in the weaving of the story of the lived experience of the participants. Connection is basic and foundational to the experience of the presence of spirituality for therapists. Connection in the presence of spirituality is also profound and deep. It is described as foundational for Fraser, "I just try to be accepting of them as people who are working out their own sense of truth in the world, and just try to accept that that is where they want to be and where they are." David phrases it this way, That kind of immediacy in intimacy, connection, relationship- that immediacy of love for the person, and for the relationship, that I think is foundational to how I want to work with the person, how I want to explore with the person, and so I really try to bring myself to that place first, and I think that that is an expression of love, but it is also my way of inviting love into the process and wanting that to be undergirding whatever exploration, and go on from there.. .that certainly is something that is important to me. There is a sense that what happens in the connection in the therapy room is in a broad sense a spiritual enterprise. Aaron phrases it this way, 99 Carl Gustoff Jung made this interesting quote, ... "invoked or uninvoked God is always present" and that is I think part of a foundational sense of spirituality that what we do here in the consulting room isn't something that's apart from other parts of life and isn't outside the view of God or anything like that, but there is a sense of which this is a profoundly spiritual experience as two people share intimately about life, and about health, and about pain, and so on. I think that is a profoundly spiritual experience. But that is kind of, how do I say it, foundational undergirdings... Not only is there a connection that is foundational, but during the moments described, there is also an intensity of connection as described by Howard, "whenever I feel really deeply connected -1 don't know how else to describe it, and I might feel the emotions that they feel and I might feel the pain and I know I'm tearing up and I'm connected". Cara describes her spiritual moment with her client, "we really felt an incredible spiritual connection". Aaron describes the depth of connection not only related to the connection between the client and therapist but also a connection to the Creator. He puts it this way, When I feel like I am tapping something deep in the client and when I feel that the depth of my personhood is contacted - that's my [sense of the spiritual] experience there. Something very deep in the therapist who touches something very deep in the client and then the added element is that somehow there is a creator that is in touch with that at the same time. I think when that happens when there is that sense when all three parties are present with depth and with being there, it is hard to see that in any word other than spiritual. 100 11. Depth of Meaning Depth of meaning is an important theme that is present during the experience of the presence of spirituality in counselling. Aaron describes it this way, "when spirituality is present there is something of depth that is happening. It is not just a discussion. There is something that is being tapped at a peak level - something very fundamental about the person." Howard describes his experience this way, Well, it seemed like it was more than just a thought to them. That it was like a lived experience, a kind of a supernatural awareness that was pretty deep for them. That was more than just "yeah I feel like that", or "yeah I think like that". It seemed very deep for them, deeper than I sometimes see the kind of the thinking and feeling exchange that happens, it just felt deeper than that. I guess in that sense it went beyond them too, like it was beyond me. I think that's how it might be described. David describes depth of meaning as "multilevels of meaning" that are happening at the time when the presence of spirituality is particularly felt. Aaron talks about the spirituality not just being present in times of trauma in counselling sessions, much much more than that. I think that whenever there is an experience of depth, especially when seeing something that I hadn't seen before - I never knew that about myself - and sessions always start out when somebody comes in with an event, and then it proceeds to the more self-examining, and as they kind of step back and look into their life and see it in a different kind of way - that's the depth. 101 Whether it be depth of pain or depth of pleasure of depth of understanding or depth of self-disclosure or any experience of depth. Howard talks about spiritual moments as intimate and deep in response to authentic connection. He says, When clients are talking about their spiritual selves and if we are being authentic -if we are being present and real in the moment - we are talking about the most intimate parts of a person's life, because when they are talking about God -whatever they conceive God to be - they are talking about - usually pretty bedrock foundational -1 mean, this is what they are basing their life on. Aaron describes the depth of struggle that goes on in the context of counselling and spirituality, somebody who is in the struggle to find something new, to lose something old, to be healed, whatever the cost is - who is facing their life - as honestly and as courageously as they can. That's - certainly there's emotions involved in that, but there's more then just that. So it is not just an emotional experience. Its far bigger then that. He goes on to describe depth and the moreness of it, the way it is supposed to be, we are not supposed to be perfect at everything. When people have an experience of depth and I speak from my own experience, not just clients -1 think there is a sense of which we go "you know I thought I had the world kind of scoped out with everything in place... and maybe I don't have the corner on reality" and whenever there is an experience of depth, maybe I don't see things right, maybe there is more to learn. There is an openness to more of that. I 102 want to learn more about life... I want to learn about how I experience things and I think part of spirituality is the moreness. 12. Intensity of Emotional Experience Participants' stories revealed intense emotional experiences when the presence of spirituality was at its most salient. Emotions such as love, awe, joy, gratitude and honour were part of their emotional experience. Aaron reports of a transforming time with his client, "It was one of the most moving times and I think it was a very spiritual time in the true sense.. .we both actually wept in here." Howard expresses it this way, "I felt quite emotional. I felt - I wouldn't call it sad - I just felt uh tears coming, because I think I felt really connected to her and she was also crying." Esther talks about the way that the intense emotion was present as deeper spiritual growth occurred, "And so she was crying a lot and it just opened her up tremendously to exploring her relationship with God on a deeper level." Cara describes her experiences with a client that she has seen long term and has a tremendous connection with, "There have been many wonderful moments with this client. She just has a simplicity of faith that is very moving to me." Gerald talks about his experience, And I find that for me - my spirituality is quite rooted in my emotionality - not in the sense - again I'm not - I'm a conservative Baptist -1 don't even like that - I'd rather be an Anglican, (laughter). But I understand the expression very very well -I really understand the expression that people use -1 have been quote - moved in spirit many times [in session]. In the presence of spirituality in session, there is a salience of love for the participants. They describe their feelings of love for clients as "an immediacy of love for the person". Howard describes his feelings of love this way, "sometimes I really 103 feel.. .love, but it is not a distorted lustful love - it's a love that really cares and it seems a lot bigger than me - like in myself, I don't think I could really love like that". Awe is an emotion that is experienced in the presence of spirituality by participants. David says, "When either it [spirituality] is overtly talked about, or it seems to be happening - in both cases I really enjoy it. I often have a sense of awe." In describing an intense spiritual moment Howard says, "I felt all those feelings again. I felt amazed and - and excited and full of awe." Aaron puts it this way, This [working with clients] puts me in a sense of awe not only of God, but also of His creation and awe for the person that I work with. I think I have had a much deeper appreciation of the person or people that I work with and I think awe is a fair word. I think I stand in awe of each of my clients, their complexity and intricacy of their personality structure. Perhaps in some way that's given me a little- perhaps a little more - you know me, and I work with them - perhaps a little more patience. In that regard -1 would call that spirituality. Gratitude is also an emotion that is part of the presence of spirituality in session. Howard describes a time when the presence of spirituality was there for him and his client, "she was kind of basking in the joy of the moment and the freedom of it and also expressing a lot of thankfulness and gratitude." In expressing her uncertainty about what is happening spiritually in a session, Cara talks about being grateful. "I praise God and thank God for everything I've got regardless of how God worked these things to be". And she continues, "I think - mostly I think how that would have been a spiritual experience for me is that I really come away feeling grateful for those moments where the client honoured me by understanding me and what I was trying to do with him." 104 Feeling honoured to be a part of the spiritual process that is happening for the client is also a big part of the story for participants in the study. Howard, in describing an intense moment of the presence of spirituality, put it this way, I was happy that this was going on because while I - she wasn't describing it - she was just experiencing it I felt connected to [the experience as well] yeah and that it was very freeing for her and being part of that - I felt really honoured that I was kind of participating in that. David is honoured by the trust his clients put in him that allows him to walk the spiritual path with them, I think I get way more privileged information about people than anybody and that's incredible - wow. That's the awe thing again. And that allows me the opportunity sometimes to walk the spiritual path the person is on. And that's an incredible opportunity." Openness and vulnerability is a characteristic that is present when spirituality is present in the participants' stories. Aaron remarks, "I think a measure of that would be vulnerability. That the more vulnerability people display, the more humanity they are willing to, the more open to look at who they are. That's a profoundly spiritual thing." 13. Focussed Intensity When the presence of spirituality is felt by the participants in their sessions, there is a theme that emerges of focussed intensity and heightened awareness as part of their lived experience of those events. Brittany describes her experience. "I think it's that energy, it's that spiritual energy -like just to keep on - being able to keep going - be with them, and be able to sort of 105 suspend everything else and just be focussed somehow. I think that's what I mean - so that's energy." David puts in these words, In those kind of deeply spiritual connected moments .. .there's such a sense of openness usually at those times that I'm not aware of who I am in Christ, for example at moments like those. Which is interesting isn't it? It almost sounds contradictory as I say it. But my experience of what's going on in the moment is -is everything - you know. Kind of - pretty much - in those moments. Howard says of his experience, "when I'm in therapy, I'm usually not overwhelmed with those kinds of things [life outside therapy session], so there is a bit of a moment by moment living kind thing that happens and I think that really is spiritual too." He goes on to say, Well I think - here's my interpretation. When I can live in the moment and when I am fully present in the moment, not only am I freed from the embeddedness of the past and I'm not overwhelmed by anxiety for the future - I'm clearly connected to everything about that moment -1 mean everything - that sounds too grandiose (laughter) but I'm just - there's this feeling of being present and that's part of an existential connection I think- to the moment - to the person - to me - like I really don't care what other people are thinking -like you lose the sense of self consciousness. Howard goes on to describe this focus as self-forgetfulness, That to me is the essence of humility. When I am in the moment and I am not really thinking about how I am coming across. Now see, I can say this after the fact. At the moment I am not thinking about it. But to me - somebody once 106 described humility as self-forgetfulness. And I like that, because you are not really thinking about how others are construing you - you are just being you, and to me that is the most humble times in our lives, where we can just be authentic. 14. Sense of Finiteness When participants were telling their story of spirituality in session, they told of their own and their client's sense of finiteness in the awesome presence of spirituality. When there is a spiritual experience, it "gives us a sense of - I am much more limited r than I thought I was and I would like to expand my boundaries (Aaron)." When there is a connection to things beyond what we know - it is just an acceptance of our finiteness (Isaiah)". Aaron talks about his experiences of finiteness and at the same time feeling affirmed for who he is, What if there is a perspective reality that's got truth to it - it's not just all subjective. That becomes very spiritual because you think maybe God sees life the way it is - He doesn't have the distortions that I do and yeah, I am affirmed in who myself is, but also realize that reality is much bigger than me... I think there is a way in which there is quite a profound appreciation for the thickness of reality -that reality comes in many levels and it is not just kind of one unilateral that's true, but there are so many layers and thicknesses to it.. .1 get a profound appreciation for reality or what perspective there is that is true on all of this. Gerald talks about the area of finiteness in the presence of spirituality in counselling for him and the acceptance of that as becoming more true to ourselves. That whole awareness of suffering and brokenness and acknowledgement and accepting of that is not just a fact of life - which it is - but is part of how we 107 become more aware of our true kind of place in life, that we are finite, that we need to lean on things bigger than ourselves. We are more true to ourselves, we are . accepting the brokenness. 15. Dependence on God Therapists talk about praying inwardly in session as part of what they would do normally in their lives. They also expressed times when they particularly prayed in dependence on God in session. Isaiah says, God is there whether I want Him to be or not. That makes a difference to my work, because there are times when I don't feel very alive in any sense, never mind the spiritual sense and I am hoping and I mean that in a very serious way, that I am counting on there being something else going on here, because I am not big enough to make this happen on my own. Esther talks about her sessions where she experiences a dependence on God through prayer, "I guess one of the things that I would say is there are lots of times when I am there, but I am not sure what's - what I need to do or what to do, so I do depend on God." And again, when she has felt threatened by an angry client, "So I am praying for a lot of protection, because there is a lot of negative energy [angry client] coming in every direction. Ya and praying that God will bless this person with the truth, and that something will be sinking in". Brittany expresses her experience, Well you know, as I am going through a session, I'll often do a lot of inner praying and dialoguing with God in terms - in order to help me be more sensitive, to help me to get more to the deeper understanding of what the client is saying, to be willing to stay in that moment, to stay in that pain, so I use God more 108 therapeutically. I think that maybe the client would have no idea but for me, that has been much more grounding for me. 16. Sense of Self Transcendence As part of the story, participants experienced a sense of being beyond themselves in a session. They found this sense of self transcendence difficult to articulate. The participants talked about caring in a way that went beyond their usual experience. Aaron reported it this way, "So I think it was that sense, that kind of immediacy of the caring, and out of that sometimes it just felt like some wisdom, some support that kind of went a little beyond me." Isaiah talked about his self transcendence in caring this way, There is some caring going on here that is beyond me. When I don't feel like caring and I don't want to care or there isn't very much here that is appealing to me because I have to reach to that and I have to count on that being there. That's how I enter into that and sometimes it has helped me in simple ways, like being accepting of a client who I don't - nothing naturally in me would feel like caring for that person, but supernaturally I can get beyond that. Howard says this of his experience, "When - sometimes I really feel caring or compassion and sometimes it's more than compassion -it's love but it is not a distorted lustful love - it's a love that really cares and it seems a lot bigger than me - like in myself, I don't think I could really love like that". Additionally, participants found that what they had to offer in a session felt beyond what would normally be there. Isaiah talks about it this way, I sometimes felt like the words were almost tumbling out of my mouth before I really was able to have much thought about what was going on and I felt like it was put out a little differently than I might normally have, or it was so connected to, in 109 a more profound way than I think what I would normally describe as when I am doing counselling. Howard describes his experience, I feel spiritually elevated, or I feel connected but I feel like there is something more than me going on in that moment, in the connection, and also sometimes when I say something, and I don't know why I said that - you know - and that happens a lot. Like later I can maybe figure it out. But at that moment, it just seems to be this intuitive kind of thing and I said it. Gerald struggles with his explanation, I'm not kind of charasmatic bent. So this isn't stuff I look for. It just happens. And I do see - experience - one of the things that I do -1 get hunches. Okay - are they clinical hunches? Because of years of practice - are they intuition - are they of the Holy Spirit? - what?-1 don't know... We'll be talking about something that is over here (gesturing) and all of a sudden - I'll jump to something that has really not been part of the conversation at all and doesn't make any sense that I would go there and I've had kind of a surprising hit rate with that. Howard describes his experience as "kind of an intuitive thing. And sometimes I'll even say - I'm not sure where this is coming from. To let them know that it might not be based in years of theoretical (laughter) research and theory but its comin' from somewhere." Aaron remarks, And then on the other side, and unrelated, is the times when I feel those - that funny sense like something has just happened where I was moved from something beyond myself. That doesn't happen, I would say terribly often, but there are times 110 when I feel like I am moved to say something that doesn't come from - that comes from somewhere I don't know. You might want to say that was your unconscious speaking, and it likely is, but I also feel like those are times when maybe my unconscious is being moved from somewhere else than just me at that moment. Gerald describes a moment when he said something that he normally would not have but felt compelled to say, I've never -1 don't think I've done this one before where she's started telling her story and this scripture came to mind and I just couldn't get rid of it and .. .she was just really confused and I pulled out and read Jeremiah 29 .. .and I just read it to her and that was really not me - that was really not me. And 2 weeks later she wrote me and said that that was really exactly what [she needed] - so there was a real affirmation there. 17. Felt Transcendent Presence/ Intervention And then there were times when participants described feeling a transcendent presence or experiencing a transcendent intervention in the counselling session. Aaron describes a feeling of an emotional holding going on, there is a powerful sense in which there is emotional holding going on - an emotionally holding the client, but somehow there is an emotional holding from God in all of that. I think that is what I get from the client, that it is not just been held by me, he is being held by God somehow in all this, as they struggle to plumb the depths and that's a very spiritual experience for me. Howard expressed an intense spiritual experience where he reported, "it seemed like I saw some sort of glowing around her - but I don't know if I did or not" and he recalls, I l l She described the experience like God had come and filled her with warmth and had just pulled this hurtful and negative and critical part out of her and she felt very accepted and loved and forgiven by God. I felt kind of in awe and I felt a real sense of sacredness that this was really a holy and transcendent kind of experience." Often the presence of God was felt in conjunction with the therapist praying, "I was praying and I felt the presence of God" (Gerald) and Howard says, I'm praying - not overtly but as I'm attending and talking and counselling with somebody and its - its just part of who I am and I think it makes a difference. Whether it helps me see things in a different way, or empathize more deeply, or not say something that I am tempted to say or push the limit a bit and say something or whatever -1 probably would be surprised -1 think that's God or at least partly -and partly its me. I am open to that but - but partly it is the motivation and the moving of something greater than me. When there is a sense of healing happening in a session, Fraser describes it this way, "when we are on a topic of spiritual development and bringing about some wholeness where there is brokenness, I feel a little bit of the presence of the Spirit there to guide the process." David describes his experience "I do have a sense - not all the time, not most of the time - not most of the time, but I do have a sense - a good portion of the time, that I'm not in this alone. That there is something else going on." Therapists talk about direct intervention of the transcendent. Fraser reports, "We both agreed it was not accidental that she found me." David tells his story of the intervention of God, 112 And my experience of that - doing follow-up varies a little. Sometimes it's a little bit rote and just has to be done - other times something comes up for me and I think - oh I wonder how that person is doing? Someone comes to mind- there's a bit of a heart connection I guess- so some emotion is stirred about wondering how this person is doing so that was the case with this guy. I phoned him up and he -1 found out later that 30 seconds prior to my call, he had just prayed and was in desperate straights. His addiction was starting to spiral even further downwards than it had, and he had just called out to God for help. So he told me about that and obviously both of us were impressed that it wasn't us that had planned this, but obviously God. Gerald describes his experience of the presence and intervention of the transcendent in his practice and the familiarity of that for him in this way, There is a portion of the time where I just feel like something is going on here and I'm working with something that is a little bit bigger than me. And I don't - when a kid is learning to ride a bike. And in the beginning the parent grabs the back and the handle bars as the kid's like that (illustrating with his hands) right? But then when they are kinda starting to get it - the parent just runs behind grabbing the back of the seat lightly. I don't get the feeling -like the parent with the bike like that (illustrating hands on back and front) I get the feeling of that (illustrating his hands on the back of the bike). Mostly I'm riding the bike but every once in a while I turn around and realize -well there is a hand on the seat.. .that's how it feels for me. It doesn't - and another really important thing is it doesn't feel foreign. Gerald talks about the presence of evil that he had felt in a session with multiple personality disorder. He describes his feelings in the midst of the feeling of evil, "there 113 was a real - I felt very safe - I felt very safe - there was again kind of a weird calmness that came over me." When the counselling becomes very troubling, Aaron describes his experience of the transcendent in this way, "this depth is understood by God and this depth is, even if it may be troubling, it is not beyond the relationship they have with God and that gives me a powerful sense of spirituality. Howard describes the incredible feelings attached to the presence of the transcendent in a session with a client, "I feel in awe and I feel a sense of wonder again and I'm pleased but I know that that was not me solely - that there was something bigger than me that was going on." 18. Sense of Enlivenment The storytellers told of the sense of spontaneity, creativity, expansiveness and a celebration of life when there is an intensity of spiritual experience. Howard describes it this way, "I'm just really there and present so that, yeah, there's that sense of freedom and spontaneity and creativity." Fraser reports that when he senses the presence of the transcendent, he feels "reinforced and enhanced." David states, It's a spontaneous space too, so if something comes up in my mind, or in my heart that has something to do with a more explicit definition of my spirituality - it might come up, either I might speak an unspoken prayer, a silent prayer or maybe its relevant to what's going on or I might-1 don't know what I might do. Isaiah describes it this way, "When it is about playfulness in the sense of really invigorating one, and really bringing joy to one, and when it is about celebration of beauty and energy, then I think it gets spiritual." 114 Howard talks about this life giving experience as being outside the framework of the traditional, There's another piece to this, I think, and that is that sometimes in the moment those creative kinds of interventions or solutions might come up, and sometimes I might say it or they might or together we might - like I wonder if there is another way - you know and something creative and different and I've discovered that those might be pretty moving and pivotal interventions - those less traditional kinds of things". Isaiah remarks, I guess it's anything that really is about enlivening one somehow. It's about whatever really brings life, really brings forth some positive, some creative energetic dynamic process, I suppose. That to me is spiritual. That to me is taking this to a place of deeper truth and deeper experience in life, a deeper understanding of humanity-our humanity and others that we live with. So that is why it can be insightfulness, it can be emotional lived experience, it can be sometimes very focused on the spiritual in the sense of religious supernatural - anything that is about life giving. Brittany remarks, "I think you have to be very creative to be spiritual, or does spirituality create creativity - I don't know, but that creative [part is there]". David expresses his thoughts in the context of his spiritual experience, when he is either observing a session where there is a presence of spirituality, or if he is experiencing directly with a client, "There is an expansion in my being - a sense of expansion - a sense of openness and awe." 115 19 Hope Hope is a profound part of the lived story of the presence of spirituality in counselling. Isaiah reports his experience, Our connection with the Creator gives me some hope that there is not just something beyond me, but actual personal caring beyond me, and that hope is crucial for me. I try to make it pretty explicit for clients who struggle tremendously with hope. I see that as the underlying theme in problems and difficulties. People come when they are starting to lose hope and it is just always there. If they are continuing to hope most of the time, they are not coming. Hope is about the beyond and for me the beyond is supernatural. Aaron talks about hope and the importance of hope to change, Well to me that undergirds - now I say that right - usually in the first or second session - and then throughout the whole thing because I try to frame things positively and - to me hope is the key in human change and growth and development so and again to me that's a very spiritual dimension because hope means that we can change - hope means we don't have to be stuck - or that we won't regress. Hope is about future. The participants see themselves as the hope holders and for them, this is related to spirituality in session for themselves and their clients. Isaiah says, "I also see myself as the -1 have to be eternally hopeful -1 don't usually have a problem with that - that's not really a choice. I am aware of it when my clients are perpetually not hopeful and I have someone that reflects that -I become very aware that I am the one holding hope here." Hope is important as the participants link their personal spirituality with the hope they give their clients. David says, "that's where hope comes in - and spirituality would 116 mean hope as well and that hope which is really an important component for me as a therapist is only intensified because I have a hope in somebody else besides me". 20. Relinquishment and Transformation When this theme was manifest in the story, the participants were very energized in the telling. The presence of spirituality was related to a letting go of the old and an awakening to a new way of being. Participants describe this experience as distinct from other times in session. The relinquishment or letting go part of the transformation was reported for both therapists and clients. Howard describes it this way for himself, when he says, "When I let go of all my learning and my attempts to pigeon hole.. .I'm just aware - right then and there and it seems very clear and my senses are really sharp". He goes on to say, "I'm not attached to all these theories and my learning and experience.. .I'm freer to just let go with that and go with the moment." Fraser described his clients as letting go of their dysfunctional beliefs in the moments of transformation. Howard describes a client's experience during an intense moment of transformation. She was feeling as if, "this big knot of self criticism and hatred was just taken from me and I feel relinquished". Isaiah tells it this way, It seemed like that really landed, like it really was received and was used - made a difference, which also I think sometimes in counselling it is like, even when we think things are going pretty well there, sometimes, at least in my experience, a bit of holding back of optimism when they leave the office about whether they are really going to use this or whether they really believe this is something worth doing. In those situations, I haven't felt that lack of confidence about that, it just felt that this is now a part of their soul, this is how they are going to be. 117 In recounting these spiritual moments in therapy, participants describe them as pivotal and significant for clients and therapists. Howard recounts a meaningful session where spirituality was present for him and his clients and there was transformation, Finally I just said it...and that was a pivotal moment and - and very significant kind of movement in the process because - because once God could come into her sexual being and - and then come into their relationship, it kind of transformed what had gone on their before, and cleansed all those things. That seems like a very spiritual kind of thing, but it came out of the creativity of painting, that just kind of spontaneously and mysteriously because she didn't know what it meant and I didn't either at first, but then it hit me and - and then she grabbed it and he was there too and it was a very transforming kind of thing and I felt, I felt all those feelings again. I felt amazed and - and excited and full of awe. Therapists who work with abuse and trauma tell of the importance of spirituality for them and their clients. Esther talks about a session where she used EMDR and the client brought Jesus into the situation, "that has been a tremendous benefit. Tremendously healing." Brittany talks about spirituality as a sign that healing is really beginning to happen when spirituality enters in. She recounts, "I know working with people that have been traumatized, there is a growing sense of spirituality as they work through their healing process, so I know that happens and I think for me that's a sign that things are happening for my client, when I can begin to hear them begin to talk about spirituality, in whatever sense they have of it." Cara, who works with people addicted to alcohol tells about the growing sense of spirituality as they become transformed by working the 12 steps, 118 Its been really neat to see clients who come in and the first 2 steps are about - the first step is about admitting how unmanageable your life has become with your addiction and then the next 2 steps are coming to believe in a higher power and clients will come in and often - yeah they won't necessarily have any sort of specific higher power and maybe they weren't brought up with a Christian God -their higher power might be a lightbulb but its amazing how many of them as a course of working those steps come to believe in the love of Christ and - it shows that you can just by virtue of seeking - sometimes God can find you. The transformation process is a rebuilding and a renewed clarity, sometimes expressed as "an epiphany" (Howard). Fraser recounts the story of his client where she was, "rebuilding the brokenness and bringing about some wholeness into her life. Through that process, she has become somewhat more clearer about what she wants in life." Howard talks about a transforming moment for his client when the presence of spirituality was very salient, But what a healing, kind of transforming moment, because really, after that she came maybe one, or maybe two more times, and that was it. She was done. I mean there wasn't really a whole lot that I could - or that we were doing - it was more of an affirming of what had happened, and a kind of recapitulating some of the things that she had let go and that she decided to hold on to. Reflective Themes of the Presence of Spirituality in Counselling In telling their stories of the presence of spirituality in session, participants also revealed after effects of the experience for themselves. Three themes emerged from the 119 data when participants had described their experiences of spirituality and the significance it had for them. 21. Personal Participation in a Greater Purpose When therapists reflect on the particularly salient events of the presence of spirituality in counselling, they are impressed with being part of a greater purpose for themselves, and their clients. Cara describes her retrospective reflection this way, I think of it probably, mostly, as being - here's a metaphor- it's like the wake of a boat - while you're on the boat you don't necessarily know where the boat's going, but sometimes when you go to the stern, you look at the wake and you realize where the boat's been and that tells you something and you get the sense that somebody's been steering the boat. Gerald likens his participation as being a midwife in the process of new life being born. He says, You get into who they are - their humanity - the profound humanity - you really watch them struggle and grow. A lot of the work I saw really reminded me of Christ's words about that - that it's child birth - there's this incredible pain - the groaning - but then you forget it when you get the new light and when you are in a situation where you are feeling like the midwife - where there's new life being birthed - now that does not mean that my client becomes a Christian, necessarily, but that there is a newness - and again, I see that as God's Spirit working .. .1 see God's Spirit always working at bringing light into people's lives, wherever they are. But for those times - you really are the midwife. 120 Isaiah describes his participation as a sharing of a gift that was given to him. He says of his experience, Certainly supernatural, certainly beyond were definitely words that I remember thinking about or using in talking about it afterwards, and I think in one of the situations, even somebody was complimenting me on it, and I just felt like really this seemed like a gift that was given to me and I was sharing it. The sense that participants are sharing in a greater purpose can give meaning to otherwise difficult times, "I can sense that there is some value here in this person and in their situation that is beyond what I can see and I need to participate in trying to support and care for that, so that in the sense of carrying out or participating in God's caring for the world." (Aaron) The thought of participating in a greater purpose provides an anchor for participants. Isaiah reports, "That has been an anchor for me when work hasn't felt easy or hasn't felt as rewarding as I would like and that I continue to hold that as my anchor" and he goes on, "You need to continue because there is some greater purpose here, so then I persevere." 22. Personal Significance Upon reflection, the participants converse about the shared experience of the presence of spirituality in session, as significant in their own lives. Although it is the client who is most involved with the transformation taking place in the events that are told, the therapist is both presently experiencing and touching former experiences in their own lives. Howard describes it this way, I guess I felt some - some kind of love towards her and towards God too. But it was just kind of all happening at once and I felt - I definitely felt amazed. And 121 quite special because I was there and it was happening, and while I have had peak experiences, I don't know if I've been in the presence of someone else having a peak experience. So it was almost like I was joining the experience. I really wasn't having a peak experience but - it was pretty close - it was very close. Well it was more than just observing - it was like I was experiencing it with her but not quite to the same degree." Cara describes how the presence of spirituality in the work of 12 steps has impacted her. "It's occurred to me over time how the 12 steps that my clients are working - how the principles of that have trickled down into my own life. And I've been able to develop a vicarious experience of those 12 steps through my clients and trying to apply those principles in my own life". The suffering can also be significant and affects the participants' own spiritual sensibilities. Gerald talks about a painful event that has lingered for him, So we didn't get the organs harvested. It seemed like such a little thing to ask of God. The mother had just lost both her children. You know just this one little thing - but apparently we couldn't. So I stayed in the room with the little girl until she went into the autopsy room. And I did the funeral with 2 children in the same coffin and as you can tell by my voice, I am not over that yet. Gerald goes on to say, "I hear stories of abuse and that deeply distresses me, but it also effects my spirituality. It's not just an emotional reaction to a horrible situation. It is a -its like a peeling back of something deeper about humanity and about myself and about this poor woman across from me." The teachings from their spiritual experiences in counselling have remained a part of them,, "I think that counselling has taught me - has grown me spiritually by providing 122 me with questions more than answers. How I have learned from my clients. So I see it as a spiritual enterprise but one in which clearly at best, I am a participant." (Aaron). Gerald tells of a time in his experience when a client who had threatened and attempted suicide multiple times, had decided she really would die. Gerald struggled with this and with God and he expresses it as a memorable lesson. And I wasn't in good shape, but I remember that night. It was 30 below and I walked out to the ravine by our house, and it was night and there wasn't a cloud in the sky. I don't think I have ever seen the stars that bright. I was down in this ravine and I was praying and I was so mad at God and I prayed that this person would still [live] and looking back on it now, it was just my own narcissism. Come on God - but it was earnest - I was frustrated. I had come to care for this person deeply. And the word spoken to me or the impression was... You know [Gerald] just like you don't believe I do physical healing on demand - why do you think I do psych healing on demand? This is my business. Do what you are called to do. And I think my life has been a series [of these lessons]. The spiritual component of that is that spirituality has to do with boundaries too. 23. Professional Highlights There is a very real sense of enthusiasm for the work of counselling when the presence of spirituality is salient in the stories. Esther remarks of her experiences, "It is really rewarding!" David says, I really do enjoy when people talk about their spirituality -1 think something inside of me says, yeah, this is okay - this is really where core changes can happen, whatever someone's spiritual walk means to them. I think that's really where its at - that's really my favourite kind of counselling. 123 Fraser talks about the way the highlight experiences of the presence of spirituality reinforce his meaning in the work, "So it is my calling to do the work that I do and so when I have those kinds of experiences it reinforces and fulfills my sense of the calling and my sense of that meaning." Cara says of her experiences, "That was a couple of pretty special moments, I guess where I just felt like this is work I should be doing, and this is what I really deeply care about and this I think - in that sense of where God wants me to be." The Common Story Interwoven in their stories, therapists manifest an integration of their training, practice and personal sense of spirituality. Each therapist is on a personal journey of integration that is impacted by their training, occasions where they might begin integration of their learned psychological theories, opportunities of their therapy practice and the personal experiences of their own relationship with the transcendent. Through these experiences, there is evidence of a recursive merging of theory, practice and experience affecting the therapists' vision of their work and their foundational thinking. This journey leads to deeper clarity and ever evolving new questions. The presence of spirituality in counselling is enhanced by the therapist's personal framework of spirituality. The belief in a personal God that is interested in His/Her creation and the process of counselling sets the framework for an openness to a numinous and sacred context. There is an embracement of the web of connections in life from a triune perspective - intrapersonally, interpersonally and with God. There is an unguarded knowing that the experience of counselling can be a place of sacred and mysterious complexities. This vision allows therapists to forge a creative and effective therapy, by being tuned into spirituality's potency. The client's framework sanctions a bond and a 124 freedom to participate in the spiritual unfolding in therapy with the therapist. The therapist's personal spiritual journey influences the felt presence of spirituality as the familiar of their own lives becomes a part of the experience of the sessions. The sense of vocational calling adds resonance to the meaning and purpose of the spiritual in the therapeutic enterprise. The themes of depth in human experience serve to stimulate the encountering of the presence of spirituality. Spiritual processes allow the unfolding of the counselling process towards spiritual connection for the client and therapist and a recognition of the transcendent in therapy. The manifestation of the presence of spirituality in counselling is storied as both profoundly ordinary and an exultant transforming life experience. It is filled with mystery and challenging to articulate. When the presence of spirituality is particularly salient there is a felt difference. There is a deep connection forged which is out of the ordinary and which sets the scene for the profound depth of meaning to occur. There is an intensity of emotion that is both felt and expressed. Weeping, openness, vulnerability, love, awe, wonder, peace, joy, privilege, struggle, courage - all can accompany the experience of the presence of spirituality in counselling. There is a focussed intensity where self-forgetfulness is primary. There is a sense of personal finiteness juxtaposed against the immeasurability of the spiritual experience. There is a sense of work that is beyond oneself and where there is a fathomless felt presence and intervention in the experience. It's a sense of enlivenment where creativity, energy, spontaneity and celebration become part of the experience for both therapist and client. There is an undergirding of hope that is presented as crucial for both clients and therapist and is heavily drawn from the place of involvement and graciousness of the transcendent. Hope encompasses the past, the present and the future. There is a dependence on God as part of 125 the therapist's everyday lived experience that coalesces in the attendance of spirituality through prayer. The transformational experience is the culmination of the presence of spirituality and manifests in relinquishment, a new awakening, and a rebuilding of the brokenness which then becomes a part of the client's soul. It is a movement that is described as pivotal and significant to healing. Therapists reflect on their story with feelings of being part of a greater purpose, sometimes known, sometimes unknown. They have been midwives in a creative birthing process of new life. Their story proceeds as the impact of being present in the change process with clients trickles down into changes in their own lives, sometimes in wounding, and sometimes in new growth for themselves. The reflection continues, as therapists count their experiences in the presence of spirituality as a highlight of their life experience and a fulfillment and reinforcement of their own sense of meaning. 126 CHAPTER V DISCUSSION Summary of Purpose and Results This phenomenological study investigated the lived experiences and meaning of the presence of spirituality in counselling from the perspective of therapists. Three women and six men representing various modes of counselling practice, and serving a diversity of client populations, were interviewed and analysis was performed according to the phenomenological principles proposed by Colaizzi (1978), Giorgi (1975), Osborne (1990) and Polkinghorne (1989). An analysis of the transcribed interviews identified a common story and twenty-three themes of the participants' experiences of the presence of spirituality in therapy. The common story was an integration of the participants' collective experience. The twenty-three themes were placed under four headings that had unfolded naturally from the data. Under the heading of Integrating themes of Psychology and Spirituality in the Presence of Spirituality in Counselling are two themes. These themes are: (1) Integration of Spirituality in the Training Process, (2) Integration of Spirituality in the Counselling Process. There are six themes that come under the heading of Facilitating Themes of the Presence of Spirituality in Counselling. These themes are: (3) Therapist's Predisposing Framework, (4) Client's Predisposing Framework, (5) Therapist's Personal Spiritual Journey, (6) Therapist's Sense of Calling, (7) Spiritual Themes, (8) Spiritual Processes. Within the Revealing Themes of the Presence of Spirituality in Counselling, there are twelve themes. These are: (9) Mystery and Difference, (10) Connection, (11) Depth of Meaning, (12) Intensity of Emotional Experiences, (13) Focussed Intensity, (14) Sense 127 of Self Transcendence, (15) Transcendent Presence / Intervention, (16) Sense of Finiteness, (17) Dependence on God; (18) Hope; (19) Sense of Enlivenment; (20) Relinquishment and Transformation Experience. The final heading of Reflective Themes of the Presence of Spirituality in Counselling has three themes. These are: (21) Personal Participation in a Greater Purpose, (22) Personal Significance, (23) Professional Highlight. This chapter interprets these results in light of the literature review in Chapter U within the topics of: the identified themes, definitions, therapist's sense of spiritual journey, the therapist and client relationship, integration in training and practice, spiritual assessment, mystical experience, transformation, development, specific counselling processes and spirituality, and the recursive nature of the presence of spirituality in counselling for therapists. Following these topics, there is an examination of the limitations of the study and the implications for future research and the practice of counselling. The Relation of Research Results to Literature Identified Themes This study unpacks the richness of the experience of the presence of spirituality in counselling for participants. The question, "What is your experience of the presence of spirituality in your counselling?" that was asked in this study, is new to the literature. Although topics within the study's results are grounded in the literature, the themes of the experience of spirituality in counselling for therapists, represent a new addition to the body of research literature. 128 The Integration of Spirituality and Psychology in the Presence of Spirituality in Counselling There have been descriptive articles written on the challenges with the integration of faith and practice in the area of spirituality (Beck, 1991; Hart, 1989; Ingersoll, 1997; Kelly, 1994; Shafranske, 1990; Shafranske & Maloney, 1996; Tan, 1996). The current study draws experiential attention to the domain of training and issues of practice challenges in integration of spirituality and counselling. It also gives readers illustrations of ways and means that therapists have become integrated in the area of faith and practice. These training and practice themes point to the imperative of the integration of spirituality and counselling for individuals, such as these participants, whose faith is an important part of their lives. It also points to the significance of the integration of spirituality and psychology, when participants were experiencing the presence of spirituality in their counselling. Facilitating Themes in the Presence of Spirituality in Counselling The second set of themes were facilitating themes in the presence of spirituality in counselling. These six themes suggested that the therapist's framework, the client's framework, the therapist's personal spiritual journey and their sense of professional calling all influenced the presence of spirituality in counselling sessions. Further facilitating themes were spiritual themes and spiritual processes in the presence of spirituality in counselling. The participants in this study held beliefs regarding spirituality, such as the belief that spirituality is part of being human. Therefore, spirituality is always present in counselling whether or not participants or clients are aware of it. They also believed that the depth and creativity of the counselling enterprise itself is something spiritual. Their 129 faith meant that they believed in a Creator who is interested in His creation and could be experienced in a counselling session. These and other predisposing beliefs facilitated the participants' experience of the presence of spirituality in session. Related to these findings, was earlier survey research that identified that therapists who perceive spirituality as relevant in their own lives were more likely to perceive spirituality as relevant within their clients' lives (Shafranske, 1990). Research on therapists' values in counselling are also related to this theme (Bergin, Payne & Richards, 1996). Participants reported that clients also came with a framework in the area of spirituality. When clients came with a belief system that encompassed an openness to spirituality and the possibility of Transcendent intervention, the presence of spirituality was facilitated. Participants experienced that some belief systems were a challenge to the presence of spirituality in sessions where clients had beliefs that were part of a defense system that blocked authenticity. These themes of a client's framework as part of a positive influence in the presence of spirituality in counselling has not been researched. As the presence of spirituality becomes more open in therapy, opportunities to research the impact of a client's framework in the presence of spirituality in counselling will become greater. The participants' own spiritual journey facilitated the experience of spirituality. Their lived experiences of faith and being involved in a faith community provided a Weltanschauung that situated their experiences of spirituality in their professional life. Their own spiritual journey experiences were reported to give expression to some of the explorations of, and connections to their clients' experiences. Additionally, their personal spiritual journey gave rise to the profundity of hope and graciousness that was experienced for clients. Their personal spiritual journey stirred their recognition of the 130 depths of humanity in their clients. Significantly, their lived experiences with a Transcendent Presence and intervention in their own lives were congruent with their experiences in the therapy room. This experiential theme was not reflected in the current research and would be important to identify and further study, as it added a congruency and facilitated the experience of the presence of spirituality as reported by the participants. Related to the therapist's spiritual journey is the view of their work as a sense of calling. This added dimensional view gave a depth of meaning, purpose and perseverance to these participant's work. Although not studied in relation to the presence of spirituality in counselling, this theme is related to career literature as well as meaning literature (Cochrane, 1990; Wong & Frye, 1998). Further facilitating themes, were spiritual processes and spiritual themes. The presence of spirituality was facilitated in sessions when participants were engaging in counselling processes that were overtly related to spirituality. Assessments of faith in an intake, using psychological and experiential multi-sensory techniques such as journalling, art, using symbolic space, relaxation techniques, or exploring areas of people's faith experience related to other parts of their lives, were representative of some of rhese processes. Participants also found that when certain themes were present in counselling that related to people's spirituality, such as, forgiveness, relinquishment, death, loss, trauma and particular aspects of clients' faith experience, that the presence of spirituality was enhanced. Although there were related spiritual themes in the mystical literature (Anderson, 1994; Geels, 1996; Hood, 1986), they were not directly studied as part of the presence of spirituality in counselling. Descriptive writings on assessment 131 were found in the literature related to this study, and are included below under that heading (Cook & Wiley, 2000; Maloney, 1989; Peck, 1993). Revealing Themes in the Presence of Spirituality in Counselling The revealing themes emerged as representative of the intense moments of the presence of spirituality in session. There were twelve themes under this heading. The mystery and difference in the presence of the spiritual was evident in the reporting. The theme of connection was related to the literature (Rogers, 1980; Buber, 1970), however, the depth of connection the participants experienced between themselves and their clients, was described as more profound and deep during the presence of spirituality in sessions. Additionally, a depth of meaning was fully engaged in sessions where the presence of spirituality was most salient. Emotional experience was reported as intensified for both participants and clients. Expressions of awe and gratitude accompanied the experience. For some participants, when there was a presence of spirituality, the whole experience of counselling was elevated and their emotions and intuitions were more acute. The focussed intensity at these times was described as a place of self forgetfulness for therapists, in the midst of the experience of a deep spirituality. A sense of finiteness accompanied some of the participants' and clients' spirituality, as they realized the limits of humanity to deal with certain of the experiences of life. Some participants recognized their dependence on God during the moments of the presence of spirituality, and prayed inwardly. This experience resonated with their everyday experience of their spiritual journey. Participants also experienced a sense of self transcendence that was beyond what they usually experienced of themselves in their counselling during the more salient times of the presence of spirituality in counselling. 132 Additionally, there was a felt Transcendent Presence and intervention in the experience, although this was the most challenging aspect of the presence of spirituality for participants to describe. Some described the felt presence as a warmth, a sensation of peace, or as a glow. Some attributed Transcendent intervention as a presence guiding the process of bringing wholeness where there is brokenness. There was also a reporting of a sensation that the participant is not in the enterprise of counselling alone. Part of the experience of spirituality in counselling presented as a celebration. There was an expansiveness and creativity related to the experience of spirituality reported by participants in this study. Participants felt reinforced and enhanced, playful and spontaneous. Their experiences moved beyond the traditional in their interventions and included pivotal outcomes for clients. Hope has always been a part of the counselling process for therapists in general. In the presence of spirituality, hope takes on a depth of meaning that is infused with a therapist's own experience of hope, related to the Creator's positive intentions for His/ Her creations. The hope is experienced as beyond the everyday hope expressed between people as described by these participants. The experience of transformation provided the confirmation of the presence of spirituality as a resource in counselling. Some participants described this experience as a relinquishment or letting go of the old and awakening to the new. This part of the experience had descriptors such as healing, core change, transformation, an epiphany or a rebuilding of the brokenness and bringing about wholeness. These experiences were reported as major turning points in clients' lives. There is little in the literature that is representative of this set of themes, however, some of the dimensions of this part of the therapists' experience was related to the 133 mystical experiential literature (Anderson, 1994; Geels, 1994; Hood, 1986), as well as descriptive definitions of spirituality (Anderson, 1994; Benner, 1991, 1998; Chandler et al, 1992, Elkinds et al, 1988; Fukeyama & Seng, 1997; Groeschel, 1993; Richards & Bergin, 1997). These will be presented below under those titles. Reflective Themes of the Presence of Spirituality in Counselling The final themes emanated as a result of being a part of the presence of spirituality with a client, in the role of a therapist. These themes tell the story of significance and meaning that being in the presence of spirituality in session had for these participants. The participants revealed their own changes and the way in which the presence of spirituality in session was a professional highlight for them. These themes are additional to the research literature and would benefit from further study. As mentioned, the themes that emerged from this study are new to the literature. However, embedded within the themes, are concepts regarding spirituality that are related to the literature. These will be discussed as follows. Definitions Participants in this study found that the numinous and ambient factors of spirituality were sometimes difficult to articulate, and would agree with Benner (1991), that spirituality comes up against the parts of ourselves that are mysterious and complex. This study supported the proposed components of spirituality established by the theorists reviewed in the literature with some differences (Elkins et al, 1988; Chandler et al, 1992; Benner, 1991, 1998; Fukeyama & Seng, 1997; Groeschel, 1993; Anderson, 1994; Richards & Bergin, 1997). The stories were permeated with meaning, intcrconnectedness, transcendence, relinquishment and love as proposed by transpersonal definitions of spirituality. In agreement with Benner (1991, 1998), the participants in this 134 study saw spirituality as inseparable from who persons are and therefore experienced spirituality as a constant part of counselling. They discussed spirituality in broad terms as a human dimension with differing awarenesses. However, they also put forward more intense spiritual experiences in therapy, where both the client and the therapist were very aware of the presence of spirituality in their process. They spoke of the intense presence of spirituality as spontaneous and not something experienced as intentional. However, there appeared to be an openness to the experience on the part of both therapist and client which appeared to facilitate the recognition of the presence of spirituality. Additionally, clients come to counselling in an unsettled state that is described in the mystic literature, as a contributor to the intensity of the presence of spirituality in session (Geels, 1996). For themselves, the participants describe spirituality as relational, in both a horizontal and vertical sense. (Groeschel, 1993; Benner, 1991, 1998). The presence of spirituality in session was not apart from this deep relational connection. The relational also included their community of faith and rituals as a large part of their personal sense of spirituality that was brought to counselling. When the lived experience was described by participants, the presence of spirituality in session was part of the whole and could not be separated as descriptive language and study demands. Participants in this study would also confirm that these intense spiritual experiences are part of healing and growth experiences for clients and not necessarily related to trauma type experiences. The following two models are offered to help in the synthesis of the definition of the lived experience of the presence of spirituality in counselling for these participants. The models are limited in their application as they are reductionistic in taking apart the dimensions that the participants would see as a whole. However, for the purposes of study, they may be helpful to distinguish the experience of spirituality in counselling. 135 SPIRITUAL O N L Y God's Will Reborn Calling Sacred Grace Faith Sacred Texts Prayer Miracle C L I N I C A L - S P I R I T U A L Serenity Centeredness Love Wholeness Hope Trust Suffering Connectedness C L I N I C A L O N L Y Personality Mental Illness Family Dysfunction Communication Self-esteem Self-differentiation Boundaries C L I N I C A L - M O R A L Commitment Responsibility Harmful Behavior Manipulation Honesty Violence Deception S P I R I T U A L - M O R A L Commandments Golden Rule Evil Sin A L L T H R E E Healing Values i Growth/Development Guilt Forgiveness Meaning Community M O R A L O N L Y Right & Wrong Should Owe Ought Obligation Fairness Justice Figure 1. Three domains of language and meaning in therapy. Note. From "Morality and Spirituality in Therapy" by W.J. Dohery, (1999). A model by Doherty (1999), developed to differentiate language and meaning in therapy, between the issues of morality, spirituality and psychology, explicates some of the dimensions that appear in the data. In this model, the overlap of the clinical and the spiritual involves hope, connectedness, trust, love, suffering and wholeness. These are confirmed by the experience of the presence of spirituality in the counselling process with these participants. When there is intensity of experience, perhaps the session moves into all three domains in the model where there is healing (transformation), growth, 136 meaning and forgiveness. Additional elements experienced in the area of transformation would be a sense of finiteness and relinquishment experienced by both therapists and clients. In this study, participants would add the elements of mystery and difference, deep emotional experience, intense focus described as self forgetfulness, and a sense of enlivenment described as life-giving, spontaneous and creative to the overlap of the spiritual and counselling dimension. Additionally, the participants could not divorce their own sense of themselves as spiritual in their counselling. This model does not appear to reflect this dimension. Although the participants in this study confirm the domains and language presented in this model, their experience also extends the overlap of the domains. Further study would be beneficial to more rigorously define spirituality and counselling in light of these domains. Wong's model (1998), developed for the meaning literature in psychology, further describes the participants' lived experience of the presence of spirituality in counselling. He shows the awareness of the spiritual realm, the capacity to know God and encounters with the Transcendent, as part of the spiritual dimension. Additionally, this model shows spiritual beliefs and values, attitudes towards suffering, and the will to make meaning as the overlap between psychology and spirituality with which participants would resonate. Participants were aware of the impact of their own and their clients' frameworks in the intensity of the felt presence of spirituality in counselling. They were also experiencing an awareness of the transcendent and the personal meaning the experience of spirituality had for them. 137 Will to Meaning Moral Understanding | Spiritual Beliefs and Values Positive Attitudes in Suffering • Emotional States • Stress Reaction • Physical Pain • Sensation Sociocultural Context Awareness of the Spiritual Realm Capacity to Know God Encounter with the Transcendent Perception Learning & Meaning Higher Cognitive Processes Social Processes Physical Health Biological Drives Biochemical Processes Figure 2. Schematic representation of human dimensions Note. From "Spirituality, Meaning and Successful Aging" by T.P. Wong, (1998b). Additionally, there was a range of experiences reported that were related to the spiritual themes of forgiveness, letting go, trauma, loss, death as well as the experiential struggle of spirituality in people's lives. When these deeper human issues were present, participants reported that their sense of spirituality was heightened. The ineffability of the experience of spirituality sometimes led to participants' inability to discern exactly how spirituality was present in the moment of their sessions but as they looked back, they could see the hand of the Transcendent in the journey they had made with clients. Participants also found they were in private communion with God in session; a familiar stance for them in their everyday lives. 138 Participants differentiated between self transcendence and the felt Transcendent Presence or intervention. They experienced self transcendence where they sometimes found themselves operating beyond themselves, for instance, revealing hunches beyond their normal experience that clients received deeply. Some participants experienced these hunches as responding to, harmonizing with, or acting on the promptings of the Holy Spirit (Richards and Bergin, 1997). For others, this experience was a mystery, but clearly beyond what they would normally experience. This may also be related to the meta empathy that Rogers (personal communication, found in Richards & Bergin, 1997) described later in his life. Richards and Bergin (1997) describe spirituality similar to the participants' descriptions of the transformation process. Along with their clients, they experienced thoughts and feelings of enlightenment, vision, Transcendence, peak experiences and feelings of being one with God and nature. These could all become part of the moments of intense spiritual presence in sessions. This study confirmed definitions of spirituality as well as extended definitions of the experience of spirituality as they overlap with counselling. The wholeness of the definitions for these participants means that the independent parts of the definition of spirituality are not necessarily related to the intense presence of spirituality in counselling. It becomes spiritual when it is part of the whole. The current challenge could be that the definition of spirituality becomes so large that it encompasses all. It would be important to further study the differences in intense spiritual experiences versus everyday spiritual journey experiences in counselling sessions to refine the definitions. It would also be beneficial to add the experiential themes of this study to the dimensions of spirituality in the practice of counselling. 139 Therapist's Sense of Personal Spirituality One of the most striking impressions in the study was the therapists' genuine personal experience of spirituality and how that permeated their sense of the presence of spirituality in their counselling sessions. They reported spirituality as a whole life experience. They considered spiritual issues as central to their own healing and well-being and they endeavoured to practice the disciplines of their faith in their daily lives. Within the theme of spiritual journey, the participants confirm the survey research of Case and McMinn (2001), that showed that spiritual practices, especially attending church services, prayer and meditation were the most frequently endorsed for a religious subset of the sample. Case and McMinn (2001) also found that spiritual practices appeared to play an important role in the prevention of distress for religious psychologists, in that spiritual practices appear to be the first line of defense against distress, and are considered to play a very important role in functioning well as a professional. This was evident in some of the stories told by therapists in this study. These participants' personal spiritual struggles and joys contribute to their connection to themselves and others as spiritual, and leads them to look at their theories and clients through the lenses of spirituality. This study experientially confirms Shafranske's (1990) survey that found that those psychologists who perceive spirituality as relevant in their own lives were more likely to perceive spirituality as relevant within clients' lives. Further he discovered that these same psychologists' therapeutic perspectives were seen through their personal spiritual framework rather than their clinical orientation. His subjects reported relying on their subjective experiences in therapy. 140 Another outgrowth of the participants' personal sense of spirituality was a recognition of their work as a sense of calling. Lukas (1999), recognized as Frankl's most prominent protege, argues that "there is a most meaningful path for every person" (309). She recognized the internal and external sources of personal meaning. Not only are goals set from mental states and character structure, from her perspective, but meaning of life also enters from without. She proposes that Providence has designed and designated a special niche, a unique vocation for each person. Elkins, Hedstrom, Hughes, Leaf & Saunders (1988) called this a sense of mission or meaning and purpose in life. These therapists reported their sense of being part of a greater purpose in the process of therapy. A part of this calling appeared to be related to the work of therapy on God's behalf. For some participants this calling means the full exercise of compassion and caring without allowing an overdeveloped sense of responsibility to lead in taking the responsibilities home. For participants who reported experiencing stress challenges in their job, it was seen through the eyes of spiritual burnout. Unlike Maloney's (1997) sample, where the participants least commonly endorsed spiritually oriented coping, these participants turned to spiritually oriented coping for increased health. Participants described their burnout as stemming from practice issues that forced the spiritual out of practice. Possibly because spiritual practices associated with their religion is embedded in their guiding framework for living, these participants' healing path included spiritual coping such as prayer, bible reading, journalling, enjoying nature and attending church services. They also utilized counselling services for themselves. Their stories emphasized the importance of self care and not caring for others from a 'dark night of the soul'. 141 Therapist / Client Relationship Descriptions of the participants' experiences of the presence of spirituality in session are rich with connection between client and therapist. James Olthuis (1999) describes psychotherapy as "be(com)ing-with" (p. 140) in the capacity humans image God. The experience of connection with self, others and the Transcendent is evident in the participants' stories of the presence of spirituality in counselling. This deep connection is described as both facilitating the experience of the trust necessary for authentic spiritual experience, and that which happens as a consequence of the experience of the intense presence of spirituality. The intense connection was described as a pure kind of love and connection not otherwise felt in the experience of counselling. The therapists demonstrated that as the parts of themselves that hindered connection to their clients and to God were relinquished, connection, acceptance and care intensified, further promoting transformation for clients. This resonates with Buber's (1970) ideals of the healing connection in dialogue where transcendence occurs and where there is a Present Being between them. Participants also concurred with Buber (1970) in that surrendering oneself to full attention and openness to another in dialogue makes the difference between successful repair work and regeneration. Although participants were concerned with the art and craft of therapy they spoke the words of Olthius (1999) who suggested, empathy and attunement are more crucial than technique and interpretation. They were challenged to create a connection where persons were able to put down their defenses, where their core selves could be present and where souls could touch. Integration in Training and Practice Those participants who provided detailed descriptions of their training and the solo struggle to integrate their learnings are confirmed in the literature (Kelly, 1994; 142 Shafranske, 1991; Shafranske & Maloney, 1996). In the year 1994, Kelly sent out a survey to psychologists confirming that there was no complementary training in psychology and religion for the participants who answered the survey. It seems that for those participants in this study for whom the struggles of integration were most salient, this is still the case. Differences were noted between participants in this area in their experiential reporting. This may or may not be due to training opportunities for integration. Kelly's (1997) study of variously accredited counsellor training programs found that although 95% of respondents thought that religion was important in counsellor training, 50% are not including the subject or having supervision regarding the subject included in their programs. Courses such as Macknee (personal communication, April 19, 2001) and Patterson, Hayworth, Turner & Raskin (2000) successfully combine directed readings of psychology and spirituality and provide opportunities for training counsellors to become more integrated in their understanding of their personal experience of spirituality in relationship to counselling. Language is commonly learned as part of the training for any degree including the degree of psychology. It was noticed, for some participants, that despite the ineffability of spiritual experiences, the lack of opportunity for integration of the language of spirituality in training left participants further struggling to clarify what was happening in sessions when the presence of spirituality was evident. One participant described not having had the opportunity for integration in training or in dialogue with colleagues around the presence of spirituality in counselling and took the opportunity of the study to increase his own understanding as he grappled with articulating his experience. Beck (1991) had reported conflicts in practitioners between their professional practice and their spiritual beliefs and practices. There were reported differences by 143 participants of this study. There was some tension between Christian faith, beliefs and practice reported by some participants and others who seemed to have resolved these issues to their satisfaction and did not report conflict. It is not known why there were differences. This may have been because of a longer time line in the profession as a practicing Christian therapist, or it may have been their opportunities to integrate their faith and their psychology. Perhaps some participants have differing belief systems where integration and experience would not rectify their conflicts. This also may be an interaction between the participant's stage of spiritual journey and their stage of professional journey. Participants also felt integration issues with their place of practice. It was noted that there were levels of this type of tension between the participants as well. Some had concerns of bringing forward the issue of spirituality in an intake form or interview. Others in comparable practice organizations felt freer to do so. Some participants were concerned about the ethics of talking about spirituality overtly while others were quite convicted of the ethics of not doing so. All the participants were concerned about being highly sensitive to the openness of clients to spirituality and were very aware of their own biases towards spirituality. Even though they appeared to be at different places in their integration they were sensitive to the impact of their views. Tan's (1996) descriptions of implicit and explicit integration in practice were complex for these participants. Only one person explicitly reported practicing spirituality in counselling as Tan (1996) defines it. This participant reported using interventions of prayer and Bible reading systematically with her Christian clients, emphasizing the spirituality of both the client and the therapist as foundational to effective therapy, being careful to practice in a sensitive way. The remainder of the participants did not fit the 144 model of explicit integration nor implicit integration. They did not practice using spiritual resources such as prayer or sacred texts in the session in a systematic way, rejecting that as technique rather then relationally and situationally appropriate. They reported rare occurrences (I never do this or I rarely do this) of prayer or references to scripture explicitly. However, they did use metaphors and stories related to their faith if it seemed relevant. They were also open to dealing with spiritual experiences as related to psychology and did not report referring when they came up as part of the session. However, the reported spiritual experiences were related to their clients' psychological functioning and not to their theology. Participants did have beliefs and experiences where the incorporation of spiritual resources were transforming and believed that spirituality was appropriate and preferable as part of counselling (Holmes, 1994; Payne, Bergin, Bielema & Jenkins, 1991; Richards & Bergin, 1997). This does not seem to fit with the model of implicit versus explicit integration in practice. Opportunities of clients' openness to the area of the presence of spirituality in counselling, seemed to be validated in this study. Kagan's (1998) prediction that clients would be increasingly open to spirituality resonates with participants in this study. Although only two participants work in a distinctly Christian counseling center, most therapists found that spirituality was very much a part of their practice. It was sometimes a surprise and always gratifying to them to find that clients were so open to a sense of spirituality in whatever form. Participants' experience of spirituality in therapy also included the possibility of dysfunction, where religion acted as a control or socializing force to suppress pathology or clients used religion as a defense against authenticity. This concurs with descriptions 145 of the challenges and health of spirituality in therapy by Spilka (1986) and Pargament (1996). Other issues brought up by the American Psychological Association code of ethics (1992) and relevant to practice integration include competence, respect for beliefs and values, and effectiveness of therapy. Competency to practice spirituality was brought up as a concern for some participants, when they considered the current interest in spirituality in the field of counselling. They were particularly concerned about the presence of spirituality becoming a new 'fix it technique' instead of a holistic, authentic life experience for therapists and clients. Finding appropriate integration training continues to be a challenge for some participants, however, participants stated they could not practice without integrating their spirituality and their counselling as part of their value system. Their experience appears to be in agreement with Beutler, Machado and Neufeldt (1994) and Shafranske and Maloney (1996) who suggest that in practice, one's professional and one's personal values become so entwined it is virtually impossible to separate them. Chappelle (2001) and Hall and Hall (1997) suggest that therapists need to understand the role of the therapist and the boundaries of therapy as part of the issue of competence. It would seem that the participants in this study were concerned with their role and their boundary issues, while at the same time, when the issue of spirituality was in the counselling session, they were focussed on its place in the effectiveness of therapy and the promotion of the welfare of the client. The participants' stories included their respect for their clients' spiritual or nonspiritual orientation, although a formal informed consent around the context and use of spirituality in sessions was not evident as recommended by Hall and Hall (1997). The effectiveness of the presence of spirituality in therapy was of most concern to participants whose client issues represented a misuse 146 or abuse of spiritual resources in the past. Of equal ethical importance however, was the concern over the failure to take into account a client's religious and spiritual values and not consider integrative treatment that may be required by the client, or not honouring the client's spiritual voice in therapy (Gustche, 1994). The stories of therapists seem to have an attitude of co-exploration when the area of spirituality and psychology was present in their sessions. Their humility, honour and the state of not knowing was evident in their stories. Their spiritual connections were beyond denominational affiliation and faiths. As Griffith (1999) suggests, these participants appear to have been able to move from the state of "certainty to wonder" (p.211) in regards to their spiritual beliefs in counselling. They were concerned that they did not exhibit both "prescriptive constraints - that this God talk is not to be spoken here, [or] prescriptive constraints - that God can and should be spoken of here, but only in a certain way " Griffith, (1999). It was evident they held this ideal and were concerned that it be apparent in their counselling. Griffith (1999) offers four certainties that these participants showed evidence of resolving: I know what God is like for you because I know your religious denomination.. .1 know what God is like for you because I know what your language about God means... and I know what God is like for you because your image of God is a reflection of your early attachment figures... [and] I know what God is like and you need to know God as I do. (p. 212-219) In their second interview, therapists remarked how much they enjoyed the opportunity to have a voice regarding their experience of spirituality in counselling, how they could see their progress in their professional integration journey, and how much they looked forward to the continuation of their journey. They would echo Brokaw 147 (1997) on the practice of integration as "one of the most exciting rides of life - the heart of life... personal and professional growth" (p. 81). Spiritual Assessment Peck (1993) and Maloney (1989) have described the area of spiritual assessment in counselling as a preferable way to bring about the possibility of full expression of being human in counselling. The only formal assessment of spirituality reported by this group of participants occurred under the umbrella of drug and alcohol. The participants who reported the application of assessment described its use as Peck (1993) proposed, including gaining an awareness of an individual's notion of God, the relationship of the individual and God, as well as prayer and other spiritual experiences that may effect an individual. Other participants appeared to know where their clients were in their sense of spirituality and may do this informally as the sessions proceeded. Maloney (1989) has laid out a spiritual inventory to find the most enhancing way of working with a client's sense of spirituality. Participants experienced differences in a clients' spirituality in session where it could be helpful, or a defense against health, and some may have found Maloney's adjustment assessment helpful. However, because their preference was for a deep connected relationship around the issue of spirituality, it is hypothesized that these participants may agree with Cook & Wiley (2000), that assessment instruments introduce an emotional distance in the therapy and that the experiential interview is the most effective means to assess the client's sense of spirituality. Extrapolating from their reports, it might also be suggested that these participants are unaware of these assessments due to the nonintegration of counselling and spirituality in training. Possible practice restrictions may also be operating. One participant reported rejecting employing a spiritual assessment because of the restrictions of working in a secular agency, and a 148 belief that society had far to go before accepting spiritual experience as a value that could be overtly and typically assessed in counselling, rather than randomly and in response to a client's introduction. Mystical Experience Anderson's (1994) suggestion that therapists need to relinquish their wishes and attempts to change clients and their relationships in the face of transcendent experiences, was borne out by these therapists' reports. These participants naturally let go and supported their clients in their freedom to experience during intense spiritual experiences. Therapists reported being observer/ participants when clients relinquished, forgave or had an epiphany. These were significant transformation points for clients, as the mystical literature suggests of these experiences. Two participants included spontaneous visions as part of their experience of the presence of spirituality in counselling as Geels (1996) reported. The experiences were interpreted as an encounter with an Ultimate Divine Reality and engendered a deep sense of unity for both the client and the therapist. There was an escalated level of experiencing than would normally occur for the client and the therapist. The experiences, as reported by the participants, matches Geels' (1996) research where the event has far reaching consequences in the life of the experiences For those who reported profound mystical experiences, Geels (1996) phases are affirmed by the participants. In the first phase Geels (1996) found his subjects had some kind of religious socialization, and a degree of psychological stress. Although the participants in this study had matching experiences, they also reported times where the socialization process may be one that clients were currently rejecting even as they were experiencing the mystical experience. The second phase was about self surrender and a shift to a receptive state. Geels' (1996) subjects were relaxed or going to sleep when they reported 149 their religious visions. The participants of this study reported deep connection, trust in the process of counselling, surrender and openness as part of this stage. The third phase is akin to transformation in this study and revealed intense emotions, positive qualities and visual qualities which the clients and the therapists interpreted according to their own experience. The final phase of verification showed that Geels' (1996) subjects found a profound sense of new life where their private dimensions of religion were concerned. The participants of this study described feeling closer to God personally and a renewed sense of faith perspective for their clients. They also described psychological life change that related to the reason that clients had originally come to counselling. As mentioned, participants in this study who reported mystical type experiences would not necessarily agree with the findings of Hood (1986) whose subjects reported to be intrinsically devout persons. Extrapolating from the data, psychopathology was not related to mystical experiences in these participants' experiences. As with Hood's (1986) subjects, various conditions seemed to trigger mystical experiences and neither participants nor clients seemed to have intentional control over this. Anderson's (1994) research adds a dimension that resonates with the reporting of these participants. He suggests that transcendent experiences occur in a time, space and story that transcend our ability to control, analyze or fully explain them. He goes on to suggest that an awareness of a Source of Power and meaning that lies beyond ourselves and yet acts on us within our concrete lives is apparent in transcendent experiences. Transformation The revealed experiences of the presence of spirituality in counselling are the culmination of all the themes for the participants. Descriptions were deep-felt as the participants described the transformation experience of clients that they were privileged 150 to share in. They described the experience as one where self awareness in the form of finiteness and vulnerability occurred. There was a sense of openness, which could lead to letting go. The experience was emotionally moving where intense feelings of awe were present. For some it was described as a peak experience, for others it was described as a time of core change, where the transformation reached the deepest parts of the client. For some participants, the intensity of the transformation was described as the completion of counselling, where the next sessions were to confirm the experience as it had happened, and to reaffirm the changes made. Holmes' (1994) experiences of the presence of spirituality in session with substantial healing effects, a resolution of shame, a reconciliation with the spiritual part of the clients and the comfort of a Spiritual Presence would all be confirmed by this research. Development and Spirituality within Counselling Possibly because of the focus of the presence of spirituality in counselling, the area of development and spirituality as presented by Worthington (1989), was not salient in the majority of participants' reports. There were reports of children and their sensitivity and openness to the area of death and the development of a concept of God, as a part of spirituality and counselling. Groeschel's (1987,1993) stages of spiritual development were most prevalent in the alcohol and drug reports of participants where awakening to transcendent reality, moral integration, relinquishment, the struggle to go beyond a cognitive knowing, and finally the relinquishment of the need to control God and the events of life by one's behaviour were reported. Fowler's (1996) stages were not explicitly identified in this study. However, during the transformation experience there was a centering and formation of values and beliefs giving coherence and direction in clients' lives. 151 Participants and clients were also enabled to face the limits of human life while relying on that which was ultimate in their lives. Participants saw their clients as being in various places on their spiritual journey. Some participants reported parts of their own stages of spiritual development as related to their experience of the presence of spirituality in session. Specific Counselling Processes and Spirituality This research confirms the application of spirituality in the 12 step program (Hopson, 1996). Participants reported that they enjoyed the ease with which they and their clients were able to focus on spirituality. Therapy included spiritual experiences around the themes in this study such as relinquishment, forgiveness and the recognition of our finitude. The reports related to these participants were more the journeying around spirituality rather than the intense mystical experiences that were sometimes reported by other participants. The experiences reported did, however, have the same elements as the other more intense incidences. There were also reports by participants of the use of cognitive behavioural therapy in rhe reframing interventions such as Propst (1988,1996) recommended. In the reporting, the intense emotional expression was not necessarily reported for the therapist, however, the sense of mystery, self-transcendence and felt Transcendence Presence and intervention was there in the story experience for both the participants and the clients. Rizzuto's (1996) psychoanalytic approach that appreciates the sacred was also borne out in this study. Therapists talked about their awarenesses and cautions in association with their own counter-transference issues and their personal faith. They also reported experiences with resistance of clients to face their own transference issues and defenses because of their faith. Symbolism was represented by one participant's story 152 where the process of using symbolic space from Experiential Family Systems Therapy facilitated the presence of spirituality in counselling. Wothington, McCullough & Sandage (1996), in their review of empirical research of religion and psychotherapeutic process and outcomes, found that the research did not focus on actual clients and only a few studies focussed on the role of religion in clients' and counsellors' lives. They suggested that with the rise of multiculturalism, therapists would need to formulate positions about the interaction between their own beliefs and the beliefs of their clients and that broader theories are needed to deal with diverse clients. It was noted that some therapists in this study had occasional tension around their own beliefs that were in conflict with their clients' beliefs. These conflicts resulted in sadness when it was perceived that the client's beliefs and experiences were not life-giving and were keeping them from positive mental health. With clients who had meaningful diverse faiths, participants were able to connect with clients around their faith, their language and the meaning that was brought into sessions in light of the client's faith. The participants would confirm what Haynes (1998) suggests, "where a therapist can find some personal experience from which to extrapolate to grasp the patient's experience, understanding certainly can be deepened". Participants' beliefs that clients were on a spiritual journey where they were doing the best they could to find truth, appeared to affirm the freedom of diversity of faiths. Therapists reported feeling energized and curious about clients' differences in faith perspective and a knowledge that they personally, did not have a comer on the truth. Respect for the process of therapy, and a commitment to the boundaries around proselytizing their faith as a part of counselling, was very much a part of the nature of the stories of these therapists' sensitivities of faith and the presence of spirituality in counselling. The participants' experiences also included their openness to 153 continued questioning of themselves and their counter transference issues around their faith and a determination to err on the side of conservatism and gentleness with people in the area of their spirituality. The Recursive Nature of the Presence of Spirituality in Counselling The reflective themes in the stories of the participants in this study made it evident that their experiences of the presence of spirituality in sessions was recursive. The richness of the spiritual connection and resulting transformation experiences appeared to expand their awareness of themselves, the client and their relationship to God. The presence of spirituality elevated the experience of counselling at all levels. A sense of self forgetfulness and a sense of finiteness appeared to facilitate the intensity of spiritual presence. Participants reported having hunches beyond what they would normally have when engaging in creative and life giving transitions with clients. They were touched with awe and emotionally moved. They felt extraordinary love and extreme honour to be a part of their client's experiencing. The client's experience touched similar experiences in them which further intensified their own spiritual connections and experiencing. They reported spiritual learnings from their shared experience with clients that furthered their own integration and linked into their own spiritual journey. Those experiences brought about change in the therapist's professional and personal lives and made a difference to the following experiences in sessions. The richness of meaning in participants' experience was also related to their professional sense of purpose. These are related to the literature on existential theory, particularly Frankl (1969), who defined the will to meaning as the "basic striving of man to find and fulfill meaning and purpose" (p.35). Personal meaning has been broken down into two types of meaning by Wong (1998). The ultimate meaning of life is related to 154 "religious beliefs, philosophical reflections and psychological integration, whereas specific meanings in everyday living can be created through engagement, commitment and the pursuit of life goals" (p. 405). Participants seemed to derive both types of meaning when the presence of spirituality was a part of their counselling enterprise. They experienced their counselling practice as a participation in a greater purpose. Rather then a singular scheme of self actualization through their experience, their meaning also seems to have come from responding to and being a part of the order and interest of the Creator in creation. This experience of participation in a greater purpose evokes awe, honour and confirms their relationship with humanity and the Transcendent. Limitations of the Study Phenomenological research focuses on meaning rather than facts. Each study provides unique situations that contribute multiple perspectives of a phenomena, eventually leading to a more unified description of a shared phenomena. It would be important to duplicate this research to confirm the themes as found (Osborne, 1990). The research was subject to reliability and validity checks (recorded in detail as part of Chapter m) and included having a practicing Sikh reader as well as a practicing Christian reader. This has helped to answer the question posed by Kvale (1994), "whether the reader, adopting the same viewpoint as articulated by the researcher, can also see what the researcher saw" (p. 192). A phenomenological study is a self report study and although validated by the participants, aspects of the phenomena of spirituality are profoundly difficult to articulate. Participants are only able to report what they are able to articulate, and it is possible that some parts of the experience were not able to be reported, were lost from 155 memory, or may have been noticed in observation but were not salient to the participants at the time of reporting. Additionally, the researcher is a practicing Christian and it is possible that the researcher may have impacted the interviews and interpretations from this perspective. Future research could concentrate on practicing Christians and enlist a secular counsellor to interview participants. Research Implications and Recommendations The existential nature of phenomenology means that the research is never really complete as each study contributes to the set of knowledge. As found in the literature review, there is very little research from a therapist perspective on the presence of spirituality in therapy. This explorative descriptive study unearthed a number of themes related to the presence of spirituality in counselling which are not described in the research literature. Under the title of, Integrating Themes of Psychology and Spirituality in the Presence of Spirituality in Counselling are the two themes of: The Integration of Spirituality in the Training Process and The Integration of Spirituality in the Practice of Counselling. Under the title of, Facilitating Themes of the Presence of Spirituality in Counselling are six themes. They are: Therapist's Predisposing Framework, Client's Predisposing Framework, Therapist's Spiritual Journey, Therapist's Sense of Calling, Spiritual Themes and Spiritual Processes. Under the title of Revealing Themes of the Presence of Spirituality there are twelve themes. They are: Connection, Mystery and Difference, Depth of Meaning, Intensity of Emotional Experience, Focussed Intensity, Sense of Finiteness, Dependence on God, Sense of Self Transcendence, Felt Transcendent Presence, Sense of Enlivenment, Hope and Relinquishment and Transformation. The final heading includes the three themes of: Participation in a Greater 156 Purpose, Personal Significance and Professional Highlight. If spirituality is to be considered viable to counselling, these themes need to be brought into mainstream psychological literature. Further research, both theoretical and practical would be significant. A deepening and progressive research focussing on spirituality in counselling is long overdue. Replication research would be important to confirm the present themes in the area of the presence of spirituality in counselling. Further studies could focus on other faith groups to expand the knowledge gained through this study. There are a number of areas that could be researched regarding therapists and spirituality. As Case and McMinn (2001) suggest, future qualitative research should explore the way in which spiritual practices promote resilience and well functioning among religiously oriented mental health clinicians. The connections between a therapist's work and their deepest human commitments are evident in this study. Although there are recent theoretical and descriptive writings recognizing the training deficits in spirituality and counselling, as well as possible curriculum additions in the area of spirituality, it would be important to study how integration occurs with people who have a faith perspective. It would also be meaningful to address the issue of efficacy in researching existing training and supervision in the area of spirituality and counselling. This could lead to classes that are meaningful and helpful to the integration of spirituality in training. Areas of competency to practice spirituality would be a significant area to expand for therapists who identify as secular and those who identify as having a faith. Because this study was pervaded with the spiritual sense of self in the therapist, it would be 157 important to study a variety of therapists addressing the reality of spirituality in counselling and how that impacts their clients. It would be important to examine therapists' stages in spiritual journeying related to the work of Groeschel (1987,1993), Fowler (1996), Genia (1995) and relate those to the personal integration of spirituality and counselling. It would also be meaningful to increase the understanding of counsellors whose sense of spirituality informs their lives and work by adding to the research of counsellor development (Skovholt & Ronnestad, 1995). Integration issues may throw a different light on the stages of counsellor development with those who are also trying to integrate their spiritual selves into their counselling. Explorations of the potential growth benefits of the presence of spirituality in counselling would be advantageous. Clearly the participants in this study reported the presence of spirituality in counselling as a positive enrichment, for both clients and therapists. The transformations reported during spiritually intense times were profound, and further specific research in the domain of transformation may assist therapists to open the area of spirituality in their counselling. A more complete understanding of how spixituality becomes an agent of change would be beneficial. Specific outcome studies combining spiritual - secular integration approaches, such as those practiced by these participants, would help to add credibility to spirituality in the field of counselling. As there are no adequate counselling models dealing with the person as a holistic bio-psycho-social-spiritual being, theory needs to be expanded to include the area of spirituality as a human dimension. Therapists would then have guiding models so that they are not left to their own subjective experience in therapy. 158 If psychology is to view spirituality as a diversity, more qualitative and quantitative studies need to be done to understand the dimension of spirituality for clients. A multisystemic view of spirituality in the human personality leads to a large gap in the research and an exciting challenge to future researchers. The language of spirituality and therapy was a challenge for the participants in this study. As therapy is a conversation based intervention, it would be beneficial to study more clearly the language that therapists engage in around the area of spiritual discourse and how they might discuss these issues of life without a high degree of abstraction. Implications for Practice The current study has a number of implications for the practice of counselling. The participants in this study appreciated the opportunity to articulate their experience of the presence of spirituality in counselling, and suggested they had few occasions to do so. The themes that emerged from this study may be helpful to other therapists to confirm and distinguish their own experience of the presence of spirituality in counselling. Up to this point, counsellors have not had training opportunities to integrate spirituality with counselling, however, this study confirms Pate and Bondi's (1992) suggestion that therapists first need to address the issue of spirituality sufficiently in their own lives, before integrating spirituality into their counselling. Intentional training in the area of spirituality and psychology will likely assist therapists in this regard. If psychology accepts the view that spirituality is an important human dimension that impacts all of life and is important to people's growth and healing, then spiritual assessment, formal or informal could enhance the direction of counselling. Counsellors need to take the opportunity to learn models of assessment and learn to practice spiritual assessment in a sensitive manner. 159 Given the significance of spirituality in the lives of clients as demonstrated in this study, it would be beneficial for therapists to consider the themes of facilitation and develop an awareness of how they either block or facilitate the experience of spirituality in sessions. An implication of the findings in this study indicate that introducing spiritual forms of coping in training for those who identify a faith as the centre of their lives, may be important to ameliorate the stress of the counselling profession. Therapists need to voice their experiences of the presence of spirituality as a neglected human dimension in the practice of psychology in order to further break down the sanctions against the issue of spirituality in secular agencies. Conclusions This study investigated the lived experience of the presence of spirituality in counselling among practicing Christian therapists. The results illuminated twenty-three themes under the headings of Integration Themes, Facilitation Themes, Revealed Themes and Reflection themes of the presence of spirituality in counselling. The richness of the common story demonstrated that this experience is profound for both therapist and client and includes healing, transformation and contributes to life meaning and growth. The results of the study contribute to the field of counselling psychology by providing an experiential understanding of the presence of spirituality from the perspective of practicing Christians. The themes provide a schema not only for further study but also help elucidate the scope of spirituality in sessions for therapists and clients. The revealed themes of the presence of spirituality in transformation gives the potential of attending to the spiritual dynamic and may contribute to counselling practice for therapists and clients. The findings reinforce spirituality as a human dimension that 160 belongs in therapy and the reality that it can enhance meaning- making, hope, connection with the Transcendent, connection with others and transformation. The results also confirm that spirituality must be congruently connected to the personal experiences of therapists. We need to honour and practice the traditions of our faith as anchors to the presence of spirituality in sessions. And as we continue to research various aspects of spirituality and religion and to take apart that which is whole, we need to be mindful not to become "seduced by our certainties and attempt to provide rather than co-create the meaning of an experience with a personal God with our clients" (Griffith, 1999, p.220). 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Wong, P.T. & Fry, P.S. (Eds.) (1998). The human quest for meaning. Mahwah, NJ: Lawrence Erlbaum Assoc. Worthington, E.L. (1989). Religious faith across the life span: Implications for counseling and research. The Counselling Psychologist, 17 (4), 555-612. Worthington, E.L., Kurusa, T.A., McCullough, M.E., & Sandage, S.J. (1996). Empirical research on religion and psychotherapeutic processes and outcomes: A 10-year review and research prospectus. Psychological Bulletin. 119 (3), 448-447. Wulff, (1996). The psychology of religion: An overview. In E.P. Shafranske (Ed.), Religion and the Clinical Practice of Psychology, (pp. 187-214).Washington, DC: American Psychological Association. 171 APPENDIX A BRACKETING The intention of this appendix is to acknowledge some of my life experiences concerning the area of spirituality and to make known the process of my self-reflection regarding the biases and assumptions I have, regarding the phenomena under study. Acknowledging my experiences helps them to become more salient in my consciousness, aiding me to consciously put them aside, while I am hearing the lived experience of my co-researchers. Additionally, acknowledgement allows the reader to review my biases in order to determine how these have entered into the illumination of the phenomena under study. I am a single divorced woman with 2 grown children. I was raised in a relatively conservative Christian home and church. My faith has always been important to my life and as I have grown older it has become increasingly more meaningful. Although much deeper and larger than in my childhood and youth, the roots of my relationship with God and the values that come from the experience of God in my youth, continue to have an impact on my life in an involved way today. My adult experience of a relationship with God, as transcendent and as a part of suffering and healing, gives me experiences that I likely share with my co-researchers who identify themselves as Christians. These shared experiences will need to be bracketed in order to hear the participants' stories in a fresh new way. I began to be most interested in psychology during my first pregnancy. I avidly read child development theories and parenting books as well as relationship books. I was keenly interested in discovering the uniqueness of individuals and the commonalties that 172 we share as humans. Later, I was able to pursue this interest in a formal way through university, and I worked my way through a B.A. in psychology and now an M.A. in counselling psychology. During this formal educational period in my life, I found I needed to separate my faith from my learnings because there did not seem room for the integration of the two. When I needed to investigate my own theory of counselling during two of my courses, I especially experienced the lack of integration on a theoretical and experiential level between my faith and my theories. On my own, I began to read Kierkegaard, Jung and Satir who saw individuals as holistic with an important spiritual dimension. Additionally, I spoke with other students in my faculty who were also experiencing difficulty with the integration of their faith values and beliefs and the theories being presented. I began to realize that spirituality was becoming a theme that was increasingly important to students, as they occasionally mentioned the concept in class. I also noticed, however, that the ideas of spirituality which were mentioned by students in class were taken from eastern religions, First Nations religions, holistic ideas of medicine or from mother earth ideas in feminist thought. There did not appear to be a voice of spirituality for Christian thought. Further to these frustrations, I was also coordinating and supervising a volunteer counselling service that was attempting to integrate and practice a mental health perspective and a spiritual perspective. I began to read Benner and other theorists from a theological and psychological perspective who were attempting to integrate psychology and theology. Although I have given a workshop on the subject of "soul care" or "spirituality and psychology" it remains theoretical to the actual practice of counselling. These experiences will also need to be bracketed to clearly hear the participants experience of the presence of spirituality in counselling in this study. 173 For the current research study, I have read literature in the area of spirituality from a psychological point of view, as well as some psychological writings from a theological point of view. These theoretical readings and experiences have given me some suppositions about what spirituality might look like, and might operate like, within a counselling session. Although theoretical, these will need to be put aside in order to hear the actual lived experience of the participants of the study in the area of their spirituality and counselling. Over the past 5 years, I have worked in a mental health setting and private practice. I am often aware of the spiritual searching that people experience and its relatedness to the challenges they are facing. I also feel inadequate to deal with these issues in a way that remains true to my training as a therapist and true to my experience of spirituality in my own life. I attribute this to a lack of clinical models, lack of training in the area and lack of experience. This has led me to many questions around spirituality and counselling practice. Considering the lack of research to back up the descriptive writings, my beginning question of experienced therapists with the same faith perspective would be "What is your experience of having spirituality present in your practice of counselling?" This question will serve as a beginning awareness in the research literature of this complex topic for psychology. My motivation for making the focus of the question specifically geared to those identifying themselves as Christians are several. One is that most people in this country identify themselves in some way to a Christian heritage and a Christian God, therefore, it is assumed that our clients will also predominately identify themselves as Christian. The other is that spirituality is being researched from other faith perspectives (i.e. First Nations and Jewish traditions) and needs to also be researched from a Christian 174 perspective to fully illuminate the issue. Lastly, to continue my own journey of integration, I am interested in how therapists who identify themselves as Christian and who are also counsellors handle this issue. This section has described my evolving-interest in my subject and how I came to the question for the study. Although I have had sufficient descriptive and anecdotal information around the needs of people in the area of spirituality and counselling, I have come to be extremely curious about the lived experience of Christians who are therapists and how they work with the area of spirituality in actual practice. I have attempted to understand spirituality and religious beliefs in a psychological context by taking courses on marriage and family at Regent College where the focus is towards a Christian context. I have also taken a variety of courses which have included: a) Forgiveness (offered in conjunction with UBC counselling psychology); b) a three-day conference on cultural issues including religion which was sponsored by the psychiatric department at UBC; and c) workshops on cultural concerns such as religious beliefs and marriage, family and violence and women sponsored by the Law Society. Another influence on undertaking the present study, was the fact that the department of counselling psychology was open to the methodology of phenomenology (much more than I was) unlike my quantitative research experience in clinical psychology. It was clear that the topic of spirituality was a difficult one to talk about, let alone research, and although my experience and comfort level was with a quantitative approach, I realized I would learn a whole new way of thinking about data in order to research spirituality. Due to the nature of this research, I write strongly in favour of the qualitative method and all it stands for regarding the validity of individual experience. I am more balanced in my approach and thinking about science and psychology. My 175 experience as a lab assistant, taking part in several quantitative experiments was exciting, and extended my understandings of humanity. I believe there are universals that we share as human beings and that there is an objective as well as subjective reality. I have been influenced by the writings of Ingram (1997). He writes about modernism and postmodernism in psychology and the effects of each philosophy. In an oversimplified account, he writes from a Christian perspective and uses a triangular framework of reality that includes God in all revelation. The points of the triangle are the general revelation of objective science including nature, the personal revelation of God through the reality of individual relationships or group lived experience and the special revelation that he refers to ns the text of scripture and a God transcendent position. It is the balance and the interactions of each of these three corners where we are likely to find the veracity of our spirituality and ourselves. This study argues towards one of those cornerstones and interactions, yet I recognize and affirm the validity of the other two cornerstones as well. Like most experiences of humanity, this research study likely represents the complexity of all the cornerstones, given the training of the researchers and co-researchers in an objective science, their Christian experience and their lived experience all interwoven together with their spirituality. I have enjoyed the quest for new knowledge in the area of spirituality required for this study and have looked forward to the continuing unfolding of the discovery of spirituality in counselling through the lived experience of the participants in the study. 176 APPENDIX B LETTER DESCRIBING STUDY FOR PROSPECTIVE PARTICIPANTS January 10, 2001 Dear [Participant], My name is Lynda Chalmers and I am a Master of Arts (MA) student in the Department of Counselling Psychology. As one of the requirements of my MA degree, I am conducting research under the supervision of Dr. William Borgen at the University of British Columbia. I am writing this letter to request your participation in the study that has the following purpose, criteria and procedures. The purpose of this study is to determine the experience of counsellors having spirituality present in their counselling sessions. A review of the literature shows that this subject has been neglected as a research topic in psychology. Your participation in this research will be helpful in furthering an understanding of this area. Your taking part in this research project will require an interview of approximately one hour long (to a maximum of two hours) that will be conducted by Lynda Chalmers. This interview will be audio tape recorded. After the data has been analyzed, a brief follow up meeting (approximately 20-30 minutes) will be arranged to collaborate on the final descriptions to ensure that your experience has been adequately reflected. In the interview, you will be asked to describe, in detail, one or more specific meaningful counselling experiences, where spirituality was present. Participants need to be able to identify themselves as Practicing Christians, who are regularly involved in a Christian Church. Participants also need to be experienced counsellors, trained in counselling, with a minimum of a Masters Degree. Your participation in the research study will be strictly confidential. A number code will be assigned to ensure your confidentiality and only the interviewer will know your identity. The tapes will be stored in a locked cabinet and destroyed after five years. The tapes will be transcribed on computer and the disk will also be stored in a locked cabinet and destroyed after five years. The written results of the study will be made available to you upon request. Although your participation in the study will be very much appreciated and valued, it is important to understand that your taking part in the study is entirely voluntary. Further, if you do decide to participate in the study, you have the right to withdraw at any time without prejudice. Page 1 of2 APPENDIX E PARTICIPANTS FOLLOW-UP INTERVIEW QUESTIONS 1. How do the meaning units fit with what you are trying to say in this passage? 2. How do the themes that I have come up with fit with your experience of the presence of spirituality in counselling? 3. Do the themes capture your experience of the presence of spirituality in counselling? 4. Is there anything missing in your experience of the presence of spirituality in counselling that you wanted to add? 5. Is there anything in the themes that you don't agree with? 6. What was it like for you to share your experience of the presence of spirituality counselling sessions for you? 182 APPENDIX F INVESTIGATOR TRIANGULATION QUESTIONS 1. In what ways do you think the transcripts and the themes of the lived experience of the presence of spirituality in counselling were connected to each other? 2. In what ways do you think they were not connected? 3. What struck you about the transcripts that may have been omitted in the themes? 4. What was your impression of the themes that emerged from the data? 5. How do these themes relate to your own experience of having the presence of spirituality in therapy? 6. Any other questions, comments or suggestions? 

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