Integrating Clients' Religion/Spirituality in Practice: Sources of Support and Perceived Barriers Among Social Work Practitioners

Background and Purpose: Over the past few decades, a renewed interest in the topic of integrating clients’ religion and spirituality (RS) in practice has emerged among social work practitioners and educators. Simultaneously, research is emerging that indicates assessing and attending to clients’ RS within practice can result in positive outcomes across a variety of health and mental health issues. Further, clients have begun expressing a preference for their RS to be integrated into health and mental health treatment, and for the practitioner to initiate the conversation on such a taboo topic.

To date, few studies have been done to assess social work practitioners’ views and behaviors related to integrating clients’ RS in practice. Findings from these studies indicate that practitioners have generally favorable views toward integrating clients’ RS into practice, but engage in various behaviors at a lower rate. In order to better understand the reasons for this discrepancy, two questions were included in a national survey of social work practitioners: 1)What (if anything) has helped or supported you to assess and/or integrate your clients’ religious/spiritual beliefs in your clinical practice? and 2)What (if anything) has hindered or prevented you from assessing and/or integrating your clients’ religious/spiritual beliefs in your clinical practice?

Methods: An online version of the Religious/Spiritually Integrated Practice Assessment Scale was sent to one thousand social workers identified through a therapist finder website. A total of 482 responded, and the majority of the sample were female (79%), White (87%), with an average age of 57 years (SD=11.00), closely mirroring NASW membership’s demographics.  Using content analysis, a mix of deductive and open-coding procedures, the authors conducted independent analysis of the responses to create an initial code book.  The authors met to discuss and refine codes and identify emergent themes.  Any disagreements were resolved by consensus.

Results: A total of 319 responded to the first open-ended item, and 280 responded to the second. The overarching themes that emerged when asked what helps practitioners assess/integrate clients’ RS included: personal religiosity (n=130, 40.8%), educational experience (n=77, 24.1%), and practice behaviors: practitioner initiated (n=195, 62.1%) and client initiated (n=33, 10.3%).  

When asked what prevents practitioners from assessing/integrating clients’ RS, the emerging themes included: practice-related barriers (n=50, 17.9%), RS-related limitations (n=45, 16.1%), educational barriers (n=45, 16.1%), and client-related limitations (n=95, 33.9%), such as waiting for the client to bring up RS (n=38) or the client discouraging discussion (n=29). Eighty respondents (28.6%) indicated they experience no barriers.

Conclusions and Implications: The insight provided from this national group of social work practitioners highlights the ways in which practitioners’ personal religiosity, prior training, and various practice characteristics contribute to their openness and willingness to integrate clients’ RS in practice. Additionally, though 28% reported no barriers to integrating clients’ RS in practice, three-fourths reported limitations related to clients, practice barriers, the topic of RS, and their previous education (or lack thereof) on the topic. Implications for social work practice and education will be discussed, as well as recommendations for setting a research agenda for the future.