Art review 2

Received: 28 November 2022 Revised: 5 April 2024 Accepted: 31 May 2024

DOI: 10.1002/ceas.12314

S P E C I A L I S S U E A R T I C L E

Spirituality in marriage, couple, and family counseling programs

Leila Roach1 Jose Javier Sierra2

1Department of Counseling, Idaho State University, Pocatello, Idaho, USA

2School of Counseling, Colorado Christian University, Lakewood, Colorado, USA

Correspondence Leila Roach, Department of Counseling, Idaho State University, Pocatello, ID, USA. Email: [email protected]

Abstract An increased emphasis on the importance of including spir- ituality and religion in counseling places systemic family therapists in a unique position due to their relational focus. However, research indicates a lack of graduate training to ensure competence in addressing this dimension. This arti- cle offers possibilities for integrating spiritual and religious issues into existing marriage, couple, and family graduate courses.

K E Y W O R D S counselor education, marriage and family counseling, religion, spiritual- ity, systemic family therapy

INTRODUCTION

A growing body of literature outlines the need for the ethical integration of religious and spiritual competencies across mental health disciplines (Aldrich & Crabtree, 2020; Currier et al., 2023; Vieten et al., 2013). Numerous researchers and practitioners have shown the value in utilizing spiritually ori- ented interventions with clients and others have provided applied resources for clinical practice in books and articles that address spiritually oriented interventions (McMinn et al., 2011). Specifically, it is important to address the spiritual dimension in marriage, couple, and family counseling because religion and spirituality (R/S) are central to family life across cultures and inform how family’s make meaning as they navigate through adversity and suffering (Walsh, 2019). Concerns regarding R/S can be a source of suffering and conflict within families, as well as a source of healing and resilience.

The mounting evidence points to the importance of integrating R/S into the mental health profession as a whole, and specifically into counselor education programs, including the marriage, couple, and family counseling specialty area. The Council for the Accreditation of Counseling and Related Educa- tional Programs (CACREP) has included language about R/S in the 2009, 2016, and 2024 accreditation standards (CACREP, 2009, 2015, 2023). This paper addresses the spiritual foundations of family ther- apy and the current state of spirituality in marriage, couple, and family counseling. It provides the

© 2024 by the American Counseling Association.

232 wileyonlinelibrary.com/journal/ceas Counselor Education and Supervision 2024;63:232–243.

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reader with possibilities for meaningful ways that R/S can be integrated into existing marriage, cou- ple, and family courses and illuminates strategies for teaching students how to work with couples and families. Based on the experience of other counselor educators (Curtis & Glass, 2002), and the experience of the authors of this article, this section will outline key student learning objectives, class design, and experiential exercises. In addition, there will be some practical recommendations on how to apply them to specific learning environments.

SPIRITUAL FOUNDATIONS OF FAMILY THERAPY

Historically, family therapy’s roots are multidisciplinary with a strong focus on the broader cultural context and interactions for understanding human behavior. With a shift away from individual pathol- ogy and labeling, came an appreciation and focus on normalcy, strength, health, and adaptiveness (Watson, 1997). This approach infused a wide range of ideas from several fields including anthro- pology, linguistics, communications theory, philosophy, sociology, biology, and engineering. Further, family therapy supported the appreciation of the role of religion in the lives of families and commu- nities of shared faith, as well as their connection to larger systems such as churches, synagogues, and mosques (Watson, 1997). Given this historical context and the clinical context of family therapy that respectfully supports the value of all viewpoints, one could argue that spirituality has the potential to be at the heart of systemic family therapy approaches (see Walsh, 2010). Even so, there is still rela- tively little written specifically regarding family systems theory and therapy and R/S issues (Watson, 1997). The tension over whether spiritual and religious concerns should be considered and how these should be integrated into effective mental health treatment still exists and is one that educators in marriage, couple, and family counseling programs are likely to encounter in their classrooms among students.

In the last half a century, the interest in spiritual and religious matters has regained relevance. Many mental health professionals including systemic family therapists began incorporating Eastern spiritual techniques such as mindfulness and yoga into Western therapy models and approaches (Aldrich & Crabtree, 2020; Kabat-Zinn, 1990, 2003; Kornfield, 2011; Park et al., 2018; Sabo & Reiter, 2022). Hodge (2015) recalls how the work of clinical psychologists and other professionals in the fields of nursing, pastoral care, social work, and other helping professions (marriage and family thera- pists, counselors, chaplains, and physicians) has been paying more attention to R/S in many of the clients they serve. This is significant because R/S is often fundamentally connected to the health and well-being of individuals and families. Others have proposed the integration of religion, in particular Christian theology, into psychological theories such as cognitive approaches (McMinn & Campbell, 2007). Roberts (2009) noted that “if family therapists are not aware of the worldviews of clients about…beliefs that have a spiritual component, they may be missing key elements that impact on issues people are trying to sort through in therapy” (p. 360). This is especially important because the literature suggests that spiritual and religious beliefs and practices can serve as protective factors to buffer mental health issues, as well as contribute to psychological distress (Aldrich & Crabtree, 2020).

Viewing R/S relationally allows clinicians to assess both the positive and negative influences across all stages of the family life cycle (Walsh, 2010). Increasing awareness of sociocultural influences that are inextricably woven into the fabric of spiritual/religious beliefs and practices provides a context to expand cultural humility and to embrace alternative perspectives so that clinicians can respectfully explore beliefs and practices (Walsh, 2019). There is a growing body of research and publications that continue to stress the need for empirically validated models, assessment approaches, and interventions that counselors and therapists can use to provide ethical and effective services to clients who value spirituality and religious affiliations as a critical part of their life (Aldrich & Crabtree, 2020; Richards & Bergin, 2005).

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CURRENT STATE OF SPIRITUALITY IN MARRIAGE, COUPLE, AND FAMILY COUNSELING EDUCATION

Despite the evidence to support the inclusion of R/S in the family counseling and psychotherapy, clin- icians report that they often do not broach these topics with clients because they do not feel adequately prepared to address the complexities surrounding spirituality and religion (Roberts, 2009; Vieten et al., 2016; Young et al., 2007). A major barrier to including R/S as part of family counseling and psy- chotherapy is the lack of inclusion of these topics in graduate training programs (Adams et al., 2015; Aldrich & Crabtree, 2020; Currier et al., 2023). Considering this, the authors suggest that training programs could begin by helping students understand their own spiritual and religious belief systems and then adopting spiritually oriented interventions as part of their overall therapeutic approach as they contextualize treatment and integrate them systematically into their practice. Matise et al. (2018) highlight the importance of providing more than a superficial training to prepare counselors to develop the level of competency needed to be able to address areas of spirituality in counseling. Preparing new counselors must go beyond presenting relevant materials and add experiential exercises that allow stu- dents to raise awareness of how their personal experiences may impact, in either positive or negative ways the counseling process, and also teach them how to implement interventions into their work with clients (Curtis & Glass, 2002; Matise et al., 2018).

Most of the attention to integrating R/S into clinical practice has been focused on individual treatment modalities with less attention to treatment from a systemic perspective. Because R/S is deeply woven into family life, special consideration to the unique needs of couples and families is an important consideration for marriage, couple, and family counseling programs. Relational systems are increasingly comprised interfaith and multifaith families that add complexity to family dynam- ics (Walsh, 2019). Differences in R/S between partners and extended family can result in increased intergenerational and relational conflict, tension, and suffering as families navigate life transitions and child rearing practices (Walsh, 2019). R/S are often related to ultimate concerns (Tillich, 1957) that seek to answer questions about what happens after death and the meaning and purpose of life. When families are met with crisis and traumatic events, such as the loss of a loved one or the devastation of a natural or manmade disaster, the spiritual life and relational bonds of those grieving are affected (Walsh, 2019). Students can be guided in how to effectively facilitate spiritual pluralism that supports mutual understanding and sensitivity to all family member perspectives. R/S beliefs and practices can provide strength to families so that they emerge stronger and with a greater sense of purpose and compassion for others following traumatic events (Walsh, 2019).

INTEGRATION OF SPIRITUALITY AND RELIGION INTO MARRIAGE COUPLE AND FAMILY COUNSELING COURSES

In teaching courses in marriage and family counseling, R/S can be integrated into several courses. An important place to begin is to assist students in gaining a deeper understanding of the definitions of, as well as the similarities and differences between the terms R/S (Briggs & Rayle, 2005). Stewart-Sicking et al. (2017) point to the challenges in creating precise definitions of these terms due to multiple and evolving definitions of spirituality across international cultures. They propose a broader definition that reflects the multiplicity of lived experiences in our contemporary culture. Specific beliefs and practices vary even among those of similar faith traditions and depend on family and cultural context. Providing opportunities for students to explore and develop their own definitions is an important aspect of understanding their spiritual development and worldview (Stewart-Sicking et al., 2017).

There is broad agreement among researchers that R/S can be conceptualized as part of a multicul- tural competence framework (Cashwell & Young, 2020; Vieten et al., 2013; Vogel et al., 2013). In general, this includes awareness of one’s own assumptions, values, biases, and personal limitations; understanding of the worldview of clients without judgment; and relevant and sensitive intervention

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strategies. Spiritual competencies developed and adopted by the Association for Spiritual Ethical and Religious Values in Counseling (ASERVIC, 2009) and proposed by the American Psychological Asso- ciation (APA) address these areas (Vieten et al., 2013) and provide guidance for integrating R/S into graduate training.

Cultural humility provides a framework for marriage and family counselors to carefully assess the intersectionality of all types of faith and nonbelief systems into a culturally sensitive treatment approach (Aldrich & Crabtree, 2020). Setting a foundation through cultural humility complements approaches that are more competency based. Cultural humility is a life-long, deeply personal process that invites marriage and family counselors into a deeper understanding of the self-of-the-therapist to increase awareness and understanding of attitudes, beliefs, and behaviors that impact the therapeu- tic alliance (Autret & van Eeden-Moorfield, 2022; Hook et al., 2017; Mosher et al., 2017; Plante, 2023). By engaging in this reflective process and attending to the ways that clients’ identities inter- sect, individually and in families, marriage and family counselors can work more effectively with the whole person in the context of their social location (Gehart, 2018). Social location, the combination of factors including gender, race, social class, age, ability, spirituality/religion, sexual orientation, and geographic location, influences how individuals, couples, and families make meaning of the world and their experiences (Autret & van Eeden-Moorfield, 2022). This becomes even more crucial in graduate training given that families have become more diverse and complex over recent years (Walsh, 2019).

The first task for counselor educators training spiritually competent, marriage and family coun- selors is to operationalize the aim of the training. Curtis and Glass (2002) proposed three categories that summarized the main goals of a Spirituality and Counseling course that can be generalized to learning experiences in other courses including expanding students’ awareness of spirituality, increas- ing students’ awareness of their own spiritual development, and increasing students’ confidence in addressing spiritual issues with clients by teaching students specific techniques. Competencies for addressing spiritual and religious issues in counseling (ASERVIC, 2009) provide some guidance for graduate training programs (Bohecker et al., 2017; Cashwell & Young, 2020). Courses in marriage, couple, and family counseling that include an emphasis on social justice as an essential part of training can focus on self-of-the-therapist and R/S as a component of multicultural counseling. Importantly, these courses increase students’ awareness and center them on gaining a deeper understanding and appreciation for the complex dynamics embedded in a family’s cultural context (Mock, 2019).

Approaches to integration

One method of addressing the integration of R/S into marriage, couple, and family graduate course- work is to examine transtheoretical and transdiagnostic approaches to integration (Stewart-Sicking et al., 2017; Tietjen, 2021). Stewart-Sicking et al. (2017) propose using a transtheoretical model known as the Ways Paradigm (Cheston, 2000) to help clinicians integrate R/S into psychotherapy. They offer suggestions for identifying and conceptualizing presenting concerns and psychospiritual themes through the way of understanding (knowledge), attending to the self-of-the therapist to include a sacred frame through the way of being (dispositions), and teaching well-researched practices through the way of intervening (skills). In this way, students in marriage, couple, and family courses can begin to see how R/S traditions and the counseling process are mutually interrelated.

Tietjen (2021) proposed an innovative approach to R/S integration using a transdiagnostic model developed for work in a Buddhist context. In general, transdiagnostic approaches focus on a limited number of evidence-based elements, principles, or processes of therapeutic change, and make use of evidence-based techniques that may be drawn from various orientations (Murray et al., 2019 as cited in Tietjen, 2021). This approach encourages individuals and families to connect to the deeper wisdom fundamental to their cultural heritage. Clinicians listen for bridges by using conceptual links between specific Western evidence-based core principles of therapeutic change and core Buddhist concepts. For example, a common principle of therapeutic change is replacing harmful thoughts. Two

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Buddhist concepts are conceptually linked that offer a way of activating cultural knowledge. These include changing our attitude toward unpleasant experience (awareness and meditation) expressed in the fourth Noble Truth, and the concept of impermanence that recognizes change as an inevitable part of life and encourages living mindfully. Appropriate therapeutic techniques for facilitating change are cognitive reappraisal and letting go (Tietjen, 2021). Marriage, couple, and family counselor edu- cators can focus on expanding students’ awareness of the connection between therapeutic principles and processes of change and R/S concepts by providing learning opportunities that listen for these bridges in client narratives. When utilizing a culturally responsive transdiagnostic approach, impor- tant ethical considerations include awareness of beliefs and attitudes held by the counselor, as well as an awareness of self in relation to the client’s cultural and R/S context. Tietjen (2021) also highlights the importance of ensuring that it is therapeutically relevant to incorporate Buddhist concepts, which is particularly important when working with couples and families who may not share the same belief system.

Other clinical scholars have proposed spiritually integrated psychotherapy (SIP), the integra- tion of psychotherapy theories and intervention strategies with spiritual and religious frameworks (ACPE, n.d.; Richards et al., 2023). One advantage of SIP is that it is grounded in psychotherapeutic approaches and enhances these approaches by being sensitive to the spiritual dimension when address- ing psychological and relational problems. “SIP simply means the bringing of attention, sensitivity, and evidence-based knowledge about the spiritual dimension into the process of psychotherapy— specifically, the way the patient is understood, and the way the patient’s problems are addressed in treatment” (Richards et al., 2023, p. 28). While the research in utilizing SIP approaches with couples and families is limited (other than Christian-informed approaches) scholars such as Walsh (2019) have emphasized the importance of spiritual pluralism in working with families. Utilizing this approach, marriage, couple, and family counselors can support the spiritual and religious journeys of all fam- ily members by respecting the dignity, worth, and potential of each member as they seek meaning, connection, and resolution of psychological and relational problems.

Teaching activities

There are many excellent instruments, tools, and exercises that have proven effective in stimulat- ing spiritual awareness (Gil et al., 2020; Hodge, 2015) in students and helping them address clients’ R/S needs and experiences. Students can be guided to expand their attention to the spiritual dimen- sion of families and to explore the significance of R/S in family life. Walsh (2010, 2019) takes a broad and inclusive perspective that identifies three areas important to assessing R/S within a family context: respectfully inquiring about the importance of spiritual beliefs and practices; exploring spir- itual sources of distress; and identifying potential spiritual resources. This approach offers students guidance in considering ethical issues and in approaching clients from a respectful, nonjudgmental stance as they seek to understand the implications of personal, family, and community faith systems as sources of distress as well as resources integral to the healing process.

When engaging students in experiential activities that facilitate conversations about spiritual and religious values and beliefs, it is essential to have a safe context in which they can learn together and increase self-awareness. Because these conversations can be difficult, setting up a structure that includes learning agreements (honoring confidentiality, speaking from an “I” place, being fully present, showing respect, etc.) can help support safety in sharing more authentic and meaningful dia- logue (Mock, 2019). With the hope of making practical recommendations for counselor educators training marriage, couple, and family students within their current curriculum, the balance of this article will focus on a brief review of the following experiential activities: Weaving a Tapestry of Life Identities and Relationships (Toporek, 2011), Six Sequential Exercises (Roberts, 2009), and spir- itual ecomaps and genograms (Hodge, 2000, 2015). These exercises can serve as a starting point for deepening counselor self-awareness and developing cultural humility. Additionally, it is important to

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introduce ways that these exercises can be used with clients so that the focus is kept on becoming better marriage, couple, and family counselors (Roberts, 2009).

Weaving a tapestry of life identities and relationships

Toporek (2011) developed an activity for teaching multicultural competence that helps counseling students examine various dimensions of identity. She outlines dimensions of identity that are prede- termined including age, gender, culture, ethnicity, race, sexual orientation, and national origin, and others that are formed by the historical and sociopolitical context within which one grew up, such as R/S. R/S beliefs address questions of ultimate concern and meaning and are deeply rooted in the very fabric of one’s historical family patterns and culture.

Building on this concept from Toporek’s activity, the instructor can provide an opportunity for students to explore salient aspects of their R/S belief systems and how these intersect with each other, and by extension, how they interact with one another when they enter a couple’s relationship. Begin by having students identify aspects of their R/S beliefs by addressing questions, such as the existence of a higher power, the meaning of life, what happens when one dies, the purpose of relationships, the role of prayer and/or meditation, what it means to be a good person, how R/S guides one’s life, and how R/S helps through difficult and challenging times. These concepts can be explored in a series of brief guided journaling activities over a few weeks.

Next, ask each student to distill their response as to how these aspects shape their R/S identity into a phrase that can be written on a strip of paper. Once the student has completed their strips of paper, ask them to weave together the strips as they would a tapestry and reflect on the ways that they intersect. What things stand out? What R/S strengths and resources were identified? Were there dimensions that were obscured by others? What sources of pain or wounding emerged? Allow time for process, reflection, and journaling.

Then place students in groups of two and have them weave these dimensions of their R/S together with their partner’s dimensions. After working in dyads, instructors can ask students to reflect on the experience with one another, posing questions such as, “What was it like for you to weave your beliefs with another person?” or “What parts became obscured as you wove these identities together?” Allowing students to complete this activity provides an opportunity to explore their own R/S beliefs and values around ultimate concerns and to gain a deeper understanding of the process that couples go through as they weave together these aspects of their lives.

This activity can be followed with a discussion of the implications for counseling couples with a focus on cultural humility. Owen et al. (2014) found that for clients with higher religious commitment, cultural humility was related to stronger therapeutic alliances and better counseling outcomes. Discus- sions that focus on how the students own R/S identities influence their perspectives, worldviews, and lived experiences can further assist them in understanding cultural biases, power, and privilege. This deeper understanding allows them to communicate the importance of R/S identities and to demonstrate respect and sensitivity for the plurality of values and beliefs within the counseling setting (Mosher et al., 2017). Further, student dyads from the exercise can be combined into groups of 4 for role-plays, where students can practice communicating curiosity and respect for the clients R/S beliefs and expe- riences. Beginning with a full classroom role-play exercise, such as the Interactive Training Model (Paladino et al., 2011), can help students build self-awareness as well as essential skills to effectively broach these therapeutic conversations with couples and families.

The six sequential exercises

In response to the growing awareness of the need to integrate R/S into clinical practice and the lack of training in many marriages, couple, and family counseling programs, Roberts (2009) introduced the

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six sequential exercises. These exercises were designed for counselors in training and practitioners in the field, to “learn more about when, where and how to work with or not work with spiritual beliefs” (p. 361). The exercises build upon each other and complement the knowledge students have gained from prior teaching activities or from the process of therapy. They are suggested as openers or starting points that help individuals and couples organize their awareness of spiritual experiences. These exercises can easily be adapted to a classroom educational experience with some minor modifications to the instructions. In addition, creating a classroom environment that cultivates cultural humility provides a safe space for students to explore the impact of their personal spiritual and religious beliefs and how these impact the therapeutic relationship when working with couples and families (Mosher et al., 2017).

The first exercise, “out in the open” is an incomplete-sentence activity intended to “warm up” the participants to start reflecting on their understanding of R/S as they experienced them in life (Roberts, 2009, p. 362). As an open-ended activity, participants are encouraged to contextualize their R/S values and beliefs by remembering where and how these values and beliefs developed. One approach is to divide students and trainees into dyads and recollect memories that help finish the incomplete sentences provided to them by their instructor. The exercise consists of seven incomplete sentences including, “Religious beliefs in my life…” or “The role of spiritual and/or religious belief in therapy…” (p. 363), which are designed to stimulate the integration of personal/familial, and spir- itual experiences with the training or therapeutic work. After students share their initial response to the unfinished sentences, they are encouraged to talk with each other for 3–4 min about how they completed the sentence. This exchange facilitates deeper reflection and new insights about their expe- riences. As an intervention, couples are recommended to team up, and share stories that help complete the sentences, constructing awareness of their spiritual journeys in a safe context.

The second exercise is “on the line” and focuses on broadening the conversation from personal experiences and knowledge to the role of spiritual and religious beliefs in family therapy and the larger society (Roberts, 2009, p. 364). It is about engaging in ideas that may provide a theoretical notion for their personal beliefs and practices. In this activity, students are introduced to statements and ideas from researchers and marriage and family counselors about R/S. Instructors can provide statements or students can be asked to bring in quotes from professional literature. Next, they are asked to quickly and without much thinking, take a position of either agreeing or disagreeing with the statement by placing themselves at the corresponding side of an imaginary line that divides the room in two. Then, they discuss the reasons why they chose that particular side or position with the other participants in their group for a few minutes. To promote richer discussions, students are encouraged to engage in these conversations with others on the opposite side as well. The opportunity to engage different perspectives in a short period of time can help students examine and clarify their own ideas, beliefs, and values. In addition, the activity can generate discussion about the differences between R/S to help students refine their own definitions. This activity can be followed by a discussion of how to engage families in this exercise. Roberts (2009) suggests using open-ended statements common to family experience such as “An important part of healing for me is my spiritual beliefs” or “Within a family there should be room for different religious and spiritual ideas” (p. 367). The intent of the exercise with families is to open dialogue among family members when there is already a basic level of trust established. Because families will have fewer members than larger training groups, they can be asked to imagine where other extended kin networks and communities would place themselves on the line. This allows family members to examine their own beliefs within the context of their community.

The third exercise in the sequence, “Rituals,” explores spiritual beliefs and practices in the daily rituals of the family (Roberts, 2009, p. 367). This exercise is based on the idea that during every- day rituals such as bedtimes and mealtimes; family traditions like birthdays, vacations, and family reunions; holiday celebrations and observances; and life-cycle rituals such as weddings and funerals; families follow customs that can reveal spiritual and religious perspectives the family holds or that others disagree with. These rituals, and their embedded spiritual assumptions, are believed to play an important role in meaning–making experiences that prepare and help families when going through

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changes and challenges. The activity begins with a time for relaxation and focusing facilitated by the instructor. Then, students are asked to think about childhood and current memories and recall rituals with spiritual and religious meaning that their families practiced and reflect on what makes these ritu- als important to them and to significant ones in their lives. This activity translates well to working with clients in family therapy as working with rituals is often used as a resource in therapy and can help family members recognize the spiritual and religious aspects embedded in rituals (Imber-Black, 2009).

In the fourth exercise, “Through the ages” (Roberts, 2009, p. 369), a genogram becomes a refer- ence point for imagery experiences that recall memories of spiritual and/or religious events in the past. The purpose is to find larger patterns throughout the extended family relationships and over the lifes- pan of the family. Students are provided directions and guided to draw their three to four generation genograms (McGoldrick et al., 2020), emphasizing the ethnic background and spiritual and religious beliefs of their family members. Upon completion of the genogram, they are presented with several questions designed to help them remember and process significant memories related to R/S. For exam- ple, what meaning does R/S have in your family’s life? What R/S rituals or beliefs did you grow up with? What or who influenced the development of your sense of R/S? Were there any family conflicts that centered on R/S differences (McGoldrick et al., 2020)? After they finish processing the questions, students are asked to take a partner on a tour of their genogram and findings. Genograms are helpful and already widely used with couples and families. Specifically asking about R/S beliefs and practices will help students create and process more meaningful experiences with families as they explore their spiritual and religious histories and see larger patterns across generations.

Finally, Roberts (2009) explains that the fifth and sixth exercises are focused on the therapeutic experience and practice and, therefore, they need to be considered together. The exercise called “Ques- tions, questions: who’s got the questions?” (p. 372) directly assesses the effectiveness of introducing and addressing R/S into the therapeutic process. After students are divided into dyads or triads, they are guided in a time of warming up by focusing on spiritual experiences they remember. Then, they are asked to answer some questions that stimulate their ability to link their family’s spiritual experiences to counseling practice. For example, what meaning does R/S have in times of danger or crisis? Are your R/S beliefs a source of connection or conflict between you and other family members? What does your R/S say about gender roles? Ethnicity? Sexual orientation or identity? How have these beliefs affected you and your extended family (McGoldrick et al., 2020)? This exercise is especially useful in helping students reflect on and recognize their spiritual and religious beliefs that could influence the therapeutic relationship with couples and families, further developing their cultural humility.

The last exercise is called “Role plays: way on into it” (Roberts, 2009, p. 374). It offers practi- cal suggestions on how to prepare and structure role-plays to make sessions more stimulating and engaging. Students get the opportunity to create scenarios and role-play them as if in real practice. Utilizing a reflecting team (Anderson, 1987) allows students to receive immediate feedback and to get ideas from the team as they engage in role-plays. Finally, reflecting on what was learned through the exercise by processing the different roles in the role-play afterward, and by developing new ideas to respond during interactions with the role-play family, can increase students’ self-awareness and skill in addressing spiritual and religious concerns.

Spiritual ecomaps and genograms

Spiritual ecomaps and genograms are two graphical tools that sketch out family dynamics and patterns in the current or generational contexts (McGoldrick et al., 2020). Hodge (2000) stresses the importance of using these two tools in tandem, taking advantage of their complementary functions. Ecological or ecomaps describe aspects of the context within which people live and outline the major systems that are part of a family’s life and their relationship to those systems (Hodge, 2000; McGoldrick et al., 2020). While the original focus of ecomaps was on the current existential functioning of the family system and subsystems, when combined with the intergenerational focus of genograms, ecomaps shift

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their focal point to the environmental systems having an effect on the family. This shift opens the door to developing a version of these instruments that emphasize the most significant aspects of family R/S practices, including their relationships with God/Transcendent, their faith communities and spiritual leaders, and each parents’ R/S traditions, all of which affect family dynamics, patterns, and lifestyle (Hodge, 2000). This approach requires collaboration between instructors and students and enhances awareness of how R/S has been and could continue to be, a resource for facing new challenges in life.

Hodge (2000) further describes how to build on ecomaps and genograms to enhance exploration of the family’s spirituality. The same approach can be effective in the classroom. As discussed in an earlier section, marriage, couple, and family programs provide curricular opportunities to construct genograms to help their students raise awareness of their personal and familial dynamics as they also learn the use of this instrument in therapeutic contexts (McGoldrick et al., 2020). It is assumed in this article that students come to this activity with some knowledge of ecomaps and genograms and perhaps, a clear picture of their family relationships. The focus here should be on depicting how R/S beliefs and practices have impacted family life. Providing students with a lecture or discussion of assigned readings on spiritual anthropology as summarized by Hodge (2000), provides students with a foundation for understanding the transpersonal element or spirit, central to human ontology. Students are then guided to review their genogram and to construct an ecomap that focuses on spirituality. The specific steps can be adapted and summarized from Hodge’s (2000) article and presented to the participants either through projected slides or a handout they can have in front of them. After the designated time, participants can share their findings with their partners and draw some ideas on how to use these instruments in practice.

DISCUSSION AND IMPLICATIONS FOR GRADUATE TRAINING

As part of this process, it is essential to consider the ethical issues that arise. The American Counsel- ing Association (ACA) Code of Ethics (2014) provides direct guidance and states that “… Whereas multicultural counseling competency is required across all counseling specialities, counselors gain knowledge, personal awareness, sensitivity, dispositions, and skills pertinent to being a culturally com- petent counselor in working with a diverse client population” (Standard C.2.a). Further, Currier et al. (2023) argue that principles and standards across all mental health disciplines including the APA, the National Association of Social Workers (NASW), and the American Association for Marriage & Family Therapy (AAMFT) all prohibit discrimination against clients on the basis of R/S along with responsibilities to address this area in clinical practice. The requirement to develop competence is sup- ported by Hathaway (2011) who points to the need for practitioners in the mental health profession to obtain at least a basic level of competence in addressing spiritual and religious issues. He identifies the harm that can occur if practitioners exhibit implicit antireligious biases and discriminate against con- ventional clients, as well as practitioners who assume a proreligious bias. Vieten et al. (2013) identify multicultural competence for psychologists that include religious and spiritual traditions. However, multicultural competency tends to focus on ethnic and racial diversity, gender, sexual orientation, and aging with limited attention to the spiritual and religious aspects of diversity.

While the focus of this article is on providing resources and experiential teaching activities for integrating R/S into marriage, couple, and family counseling courses, a broader intention is to raise awareness and advance collaborative discussions with educators across mental health disciplines. The teaching activities presented here are a sample of possible exercises that can be used as starting points in a longer and more complex process of integrating R/S into training across a wide range of disci- plines including marriage, couple, and family counselors in training. Activities that develop student knowledge, skills, and dispositions do not occur in isolation, rather they are part of a larger framework with clear goals linked to existing competencies for addressing R/S in clinical settings.

Contemporary families represent a broad range of spiritual and religious beliefs and practices often within the same family. With this growing diversity, Walsh (2019) advocates for family therapists to

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not only broaden their lens to spiritual diversity but also encourages a broadly inclusive perspective when working with families. Spiritual pluralism requires not only an appreciation of the many differ- ences between family members and communities but also a recognition of their commonalities and distinctions. Further, pluralism “involves a broad inclusiveness of people of every faith, and of none, nurturing constructive dialogue, respect, and mutual understanding, coalescing around shared values and practices” (Walsh, 2010, p. 346). As a mental health community with diverse areas of practice, we would do well to expand our collaborative efforts to advance the training of all mental health providers to competently address R/S in clinical practice.

CONCLUSION

The need to address R/S issues in clinical practice, especially for marriage, couple, and family coun- selors is evident. R/S concerns and faith differences within families impact the dynamics, structure, and functioning within the system contributing to conflict and distress, At the same time, R/S beliefs and practices can be a source of strength and resiliency as families navigate difficult times. Conse- quently, it is imperative that marriage, couple, and family counselors work with the spiritual dimention as part of their clinical practice with couples and families. One of the major barriers to integrating R/S in the clinical practice of marriage, couple, and family counsling is the lack of appropriate prepara- tion in graduate training programs. In addition, much of the current literature has focused on working with R/S within an individual context. While integration of R/S is important across all disciplines, more attention is needed to the integration of R/S specifically in programs that specialize in training marriage, couple, and family counselors.

AC K N O W L E D G M E N T S The authors wish to thank the research team of the Spiritual and Religious Competencies Project (SRCP).

C O N F L I C T S O F I N T E R E S T S TAT E M E N T The authors declare no conflicts of interest.

O R C I D Leila Roach https://orcid.org/0000-0001-6927-3187

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How to cite this article: Roach, L., & Sierra, J. J. (2024). Spirituality in marriage, couple, and family counseling programs. Counselor Education and Supervision, 63, 232–243. https://doi.org/10.1002/ceas.12314

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