Wilfrid Laurier University Scholars Commons @ Laurier Theses and Dissertations (Comprehensive) 2021 Exploring Spiritually Integrated Psychotherapy In Clinical Practice Tim Rieck [email protected] Follow this and additional works at: https://scholars.wlu.ca/etd Part of the Clinical Psychology Commons, Counseling Commons, Counseling Psychology Commons, and the Practical Theology Commons Recommended Citation Rieck, Tim, "Exploring Spiritually Integrated Psychotherapy In Clinical Practice" (2021). Theses and Dissertations (Comprehensive). 2356. https://scholars.wlu.ca/etd/2356 This Dissertation is brought to you for free and open access by Scholars Commons @ Laurier. It has been accepted for inclusion in Theses and Dissertations (Comprehensive) by an authorized administrator of Scholars Commons @ Laurier. For more information, please contact [email protected]. EXPLORING SPIRITUALLY INTEGRATED PSYCHOTHERAPY IN CLINICAL PRACTICE By Timothy William Rieck M.A. Theology: Spiritual Care and Psychotherapy Martin Luther University College 2012 DISSERTATION Submitted to Martin Luther University College In partial fulfillment of the requirements for Doctoral Degree Wilfrid Laurier University 2020 ©Timothy William Rieck, 2020 ABSTRACT Key Words: religion, spirituality, sacred, intervention, spiritual intervention, soul Over the past twenty years, spirituality and religion have gained increased attention in the field of psychotherapy. In the research of psychotherapy, psychology, and social work, there is recognition that spirituality and religion can contribute to positive outcomes when people are faced with various challenges and distresses in life. The main challenges are tied into determining how to move the research beyond the fact that spirituality has importance in psychotherapy to exploring how spirituality is integrated in psychotherapy. There are numerous questions to explore regarding the application of spirituality into psychotherapy. What is a spiritual intervention and how is it integrated into a theory of psychotherapy? How can a therapist use spirituality as a resource in therapy? Can any therapist, regardless of his/her personal beliefs and values, integrate spirituality into his/her clinical practice? Does a therapist’s perceptions and definition of spirituality determine his/her hesitancy to incorporate spirituality into therapy? These questions led me to the following research question: What is a therapist’s experience of integrating spirituality in the context of a client’s cognitive, emotional, or behavioural challenges and distresses in life? This qualitative, phenomenological study investigates the meaning and essence of fifteen therapists’ experiences of integrating spirituality into psychotherapy. This research takes place in a Canadian context where statistically, the demographic landscape reflects a spirituality that is moving towards a non–theistic perspective rather than a theistic–orientated worldview. Statistically, the Canadian landscape is less on common religious worldviews with more of an emphasis on spirituality. The Pew Research Center’s (2019) most recent survey in Canada, conducted in 2018, suggested a declining share of Canadians identify as Christian while an increasing share say they have no religion. The Angus Reid Institute (2017) identified the non-believers at 19% of the total population; spiritually uncertain 30%; the privately faithful 30% and 21% religiously committed. Secondly, in the Canadian context, the term spiritual care is associated with psychotherapy more so then the term pastoral counseling. The data analysis is guided by a phenomenological, heuristic method, which will explore the lived experiences of therapists who practice a spiritually integrated approach to psychotherapy. The implications for practice will be addressed. Table of Contents Chapter I: Introduction 1 Aim of Study 5 Chapter II: Literature Review 6 Definitions: Religion, Spirituality, and Sacred 6 The Terms Religious and Sacred. 7 The Terms Spirituality and Sacred. 12 Spiritually Integrated Approaches to Psychotherapy 19 The Historical Context. 19 Theory. 20 Reservations to integration. 21 Interventions. 23 Integration. 23 Summary. 35 Chapter III: Methodology 38 Purpose Statement 40 Research Questions 40 Central Question. 40 Interview Questions. 40 Research Design 41 Data Collection Procedure. 42 Data Analysis. 45 Summary. 46 Chapter IV: Findings 48 Spiritual Experiences 49 Participants’ Stuckness 59 Opening Up Space—Connection to Self and Therapist 63 Spirituality and Mental Health Challenges 75 Summary 81 Chapter V: Discussion 85 Introduction 85 Definitions and Perspectives 86 Summary 94 Spiritually Integrated Approaches and Perspectives 99 General Observations. 99 Common Factor—Client/Therapist Alliance. 101 Common Factor—Phenomena and Expectation. 105 Spirituality and Models of Change. 107 Models of Change—Traditional Participants. 107 Models of Change—Non-Traditional. 110 Models of Change—Contemporary Participants. 114 Conclusion 117 Chapter VI: Conclusion 123 Limitations of the Study 127 Recommendations for Future Research 127 Chapter VII: Theological Reflection 130 The Narrative – Opening Up Space 131 The Analysis – Opening Up Space 134 The Meaning – Opening Up Space 136 The Enactment – Opening Up Space 142 References 144 Appendix A: Figure 1 155 Appendix B: Figure 2 156 Appendix C: Consent Form 157 Appendix D: Information Letter 160 Appendix E: Poster 162 1 Chapter I: Introduction Throughout my life, my passion has always been to care for people. In the pursuit of that passion, I had a desire to understand my own religious and spiritual journey. I recognized that my beliefs and action within my faith allowed me to overcome a low self-esteem, insecurities, and lack of confidence; I felt emotionally crippled. It was a spiritual revelation to recognize that if the God of this universe could love me, there is no reason I cannot love myself. The foundation of my trust, hope, confidence, and belief was rooted in my spiritual experiences of God’s love and acceptance. It’s a simple concept, but profound and reframed how I saw myself. To this day, that truth resonates every time I sit in front of a person who comes in for therapy that through our interactions, they feel safe and understood in a room filled with hope, compassion, care, and acceptance. I believe within that kind of environment, a person can explore the inner terrain of how they see and understand themselves. Within their presenting challenges, engaging their religion, spirituality, or meaning-making experiences in such a way they can gain new understandings of themselves and become equipped with skills to handle life’s challenges. My college education consisted of theological training at Winnipeg Bible College and Theological Seminary which is now called Providence College (B.Th.) and Seminary in Winnipeg, Manitoba (M.Div.) and Denver Seminary (M.A.) Denver, Colorado. Over the years, I moved away from pastoral care and moved into the field of counselling. I missed and longed to contribute to the well-being of others (but not in a pastoral context) so I pursued graduate studies at the Waterloo Lutheran Seminary which is now Martin Luther College and University in psychotherapy and spiritual care. My practicums and supervision were from two agencies: Inter- Faith Pastoral Counselling and the School of Family Medicine. Upon graduating with an M.A. in psychotherapy and spiritual care, I opened up a part-time therapy practice in Waterloo, Ontario. 2 It has been and continues to be one of the most rewarding experiences of my life. It was through my private practice that churches would refer some of their church attendees for therapy since I was identified as a Christian psychotherapist because of my training and background in theology. I wondered what they were expecting that would be different than a “secular” psychotherapist. I came to realize that in the field of spirituality and psychotherapy, there was no clear unified approach in the integration of spirituality in psychotherapy. Is there something unique and separate that would distinguish “spiritual” and “secular” psychotherapy in practice? Is there a difference and how does spirituality fit in psychotherapy? What does a spiritually integrated approach look like in clinical practice? How do therapists who identify themselves as having a spiritually-oriented approach to psychotherapy integrate spirituality into their practice? It had become clear to me that there was an existing gap of practical guidelines and uniform approaches when it came to implementing spirituality into the practice of psychotherapy. In the past two decades, the definitions and application of the words “spiritual”, “sacred”, and “religious” have gained greater prominence in the research and practice of psychotherapy. Researchers in psychotherapy, psychology, and social work acknowledged that one’s spiritual and religious beliefs have contributed to positive outcomes when they are faced with various challenges and distresses in life (Arczynski, Morrow, & Englar-Carlson, 2016; Shaw, Bayne, & Lorelle, 2012; Meakes & O’Connor, 2013; Pargament, 2007; Plante, 2007; Saunders, Miller & Bright, 2010; Shealy & Qijuan, 2014). Pargament, Lomax, McGee, and Fang (2014) suggested that “sacred experiences can serve as a vital resource of purposeful living, feeling connected with a larger community, and a sense of continuity bridging the past, present, and future” (p. 249). Additional studies have shown that there is a positive association