Testing Options

Provider Self-Assessment of Religion and Spirituality

In many areas of cross-cultural counseling, self-awareness is an important aspect of providing effective genetic counseling. Self-assessment of religion/spirituality is no exception. Countertransference (unconscious ways of relating to clients based on the counselor’s history of relating to others) (Veach et al., 2003) and internal biases arising from personal or professional experiences can impact counseling sessions. Difficulties may emerge when the genetic counselor has an extreme focus on religious issues (too much or too little), avoids addressing religious concerns, feels negative or positive reactions to religion topics, or introduces inappropriate disclosures or interventions (Cashwell & Young, 2005, p. 110). When the counselor feels discomfort, he/she should be attuned to countertransference reactions that can interfere with effective counseling. These reactions may be minimized by thoughtfully examining one’s own views, reading about religion and spirituality in health care, and discussing personal thoughts and feelings in peer supervision settings.

Miller (2003) suggests questions for psychotherapists to assess their ability to work with clients on matters related to religion and spirituality (p. 56). These questions are also useful for genetic counselors to consider:

  1. Can I continue to work with this client given my own countertransference issues?

  2. Do I want to continue to work with this client?

  3. In working with this client, what limits will I set on how I will address this concern in counseling?

  4. In working with this client, how much of my own struggles with these religious views do I need to share?

  5. If I decide I cannot work with this client, who will I refer the client to for counseling? How will I bring up the referral with the client?

We suggest several assessment measures that may be particularly suited for self-assessment. Many patient assessment tools are amenable for use as self-assessment tools. For example, the Salience in Religious Commitment Scale is a short, 3-item tool that provides a measure of the importance an individual places on religiosity. When used for self-assessment, this tool may be helpful to the counselor in achieving greater self-awareness and a better understanding of how their level of religious commitment compares to their clients’. This scale asks the individual to assess the importance and meaning provided by their religious faith, and to consider how faith helps them in decision making. (Roof & Perkins, 1975). An example of a decision making scale in this tool includes: “I seldom/sometimes/often/mostly base important life decisions on religious faith.”

 

Exercise

Puchalski & Romer (2000) list the following general recommendations regarding taking a spiritual history in medical settings. Using the table below, document the recommendations you currently follow, and the recommendations that are professional goals.

Recommendations

Puchalski & Romer (2000),
p. 131

Currently follow?
Yes/No
Goal?

Yes/No
If a goal, note methods and timeline If not a goal, list barriers and ways they may be overcome

1.Consider spirituality as a potentially important component of every patient’s physical well being and mental health.

   

 2.      Address spirituality at each complete physical exam and continue addressing it a follow up visits as appropriate. In patient care, spirituality is an ongoing issue.

       
 3.      Respect patient’s privacy regarding spiritual beliefs; don’t impose your beliefs on others.
       
 4.      Make referrals to chaplains, spiritual directors, or community resources as appropriate.  

 

 

 

 5.      Be aware that your own spiritual beliefs will help you personally and will overflow in your encounters with those for whom you care to make the doctor-patient encounter a more humanistic one.
       

 

To what extent does Amanda apply these recommendations to this genetic counseling session? What could she do to increase the application of these recommendations to this case?

 

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