Assignment

Integrating Spirituality in Marriage and Family Therapy Training Suzanne M. Coyle* Christian Theological Seminary, Indianapolis

Interest is growing in how to integrate spirituality into family therapy. Closely related to this development are efforts to include spirituality in marriage and family therapy training. Students in various fields are expressing inter- est in spirituality and the desire to have it integrated into their training programs. However, not all family therapy training incorporates spirituality as part of rigorous academic inquiry while considering the personal and cultural components of spirituality in the curriculum. This article examines approaches to integrating spirituality in a Com- mission on Accreditation for Marriage and Family Therapy Education (COAMFTE) accredited program at Chris- tian Theological Seminary (CTS). A review of research on spirituality in training programs is offered as well as current approaches that address spirituality. The pedagogical approach at CTS is then explicated. The curriculum includes courses in religion and others that integrate spirituality/theological reflection with family therapy. ‘Integra- tion of Self, Systems, and Spirit’ and a Capstone Presentation that showcases an integrative method are described. Finally, implications for training in secular universities and agencies are articulated, with suggestions for future exploration.

Keywords: family therapy training, immanence, integration, spirituality, transcendence

Key Points

1 Spirituality is an important dimension to integrate into training programs given growing attention to spiritu- ality in family therapy as well as the diversification of spiritual experiences.

2 Trainees have an ethical responsibility to be spiritually literate and spiritually sensitive. 3 Spirituality is not an isolated dimension of family therapy but one of multiple diversity concerns. 4 Immanence and transcendence are complementary constructs on a continuum that includes both spirituality and family therapy.

Introduction to Spirituality in Marriage and Family Therapy

Increasingly, in recent years, family therapy has addressed the need to utilise spiritual- ity in clinical practice. Discussions focus on various aspects of spirituality, ranging from the therapist’s own spirituality to mindfulness practices for clients (Adams,

Address for Correspondence: [email protected] *Suzanne M. Coyle is Associate Professor of Pastoral Theology and Marriage and Family Therapy at Christian Theological Seminary in Indianapolis, Indiana, where she is Program Director of a Commission on Accreditation for Marriage and Family Therapy Program (COAMFTE) accredited Master of Arts in Marriage and Family Therapy program. She is a Clinical Fellow and Approved Supervisor in the American Association for Marriage and Family Therapy. Suzanne completed clini- cal training at the Ackerman Institute for the Family in New York and a Postgraduate Diploma in Narrative Therapy and Community Work from the Dulwich Centre in Adelaide. She holds a PhD in Pastoral Theology and Communications from Princeton Theological Seminary in the United States.

Australian and New Zealand Journal of Family Therapy 2017, 38, 142–155 doi: 10.1002/anzf.1195

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1995; Anderson, 1987; Anderson & Worthen, 1997; Brownell, 2014; Carlson, Kirk- patrick, Hecker, & Killmer, 2002; Erickson & Carlson, 2014; Gambrel & Keeling, 2010; Prest & Keller, 1993; Walsh, 2008). Some writings offer a postmodern per- spective on spirituality (Coyle, 2014; Griffith & Griffith, 2002; Moules, 2000; Waldegrave, 2003), while others emphasise the religious practices of institutional reli- gions (Kelly, 2002; Onedera, 2007). The Spiritual Issues in Supervision Scale (SISS) is a helpful instrument that assesses spiritual issues (Miller, Korinek, & Ivey, 2004).

Spirituality is not the same as religion; spirituality always precedes the establishment of a defined religion. When one and then several individuals share a spiritual experience, the desire to transmit this experience to others emerges (Bowker, 1997). This impulse creates an institutionalised religion, which develops its own sacred writings, rituals, and beliefs. Any religion can be devoid of spirituality. A vibrant religion, however, has spiri- tuality (Coyle, 2009). Ultimately, spirituality can be understood as an individual’s jour- ney, beliefs, and sense of connectedness to others (Miller, Korinek, & Ivey, 2006).

Another variant of spirituality and religion is theology. Theology is understood as the practice of one’s faith seeking understanding. As such, one can argue that it con- tains religion and spirituality, but focuses on the latter. Stone and Duke’s (2013) defi- nitions of theology offer helpful insights into its functions. Embedded theology includes beliefs that underlie our values and worldviews. It informs our every instinct and is rather effusive. Intentional theology is the practice of stepping back to critically reflect on innate values and beliefs (Stone & Duke, 2004).

Situating Spirituality in the Australia and New Zealand Context

Understanding spirituality and its potential contribution to family therapy is not a simple process. Merely stating belief propositions of any spirituality to directly apply them to an individual or family’s life greatly misses the point. A truly lived spirituality demands that it is woven into one’s culture to contribute to individual and family resilience (Coyle, 2016). To make this article accessible to the target audience, refer- ences to demographics about Australia and New Zealand are included to situate spiri- tuality in the Australian and New Zealand context.

The literature demonstrates growing interest in integrating spirituality in family therapy. At the same time, cultural shifts are occurring. A recent poll by WIN/Gallup International indicates that 58% of Australians consider themselves as not religious (WIN/Gallup International Poll, April 14, 2015). Furthermore, the Best Countries Survey recently reported that Australia is perceived as the least religious country in the world (Best Countries, US News and World Report, 2016).

The number of people reporting no religion in Australia has increased over the past 100 years from one in 250 people to one in five. The ‘no religion’ category includes atheist, agnostic, humanist, rationalist, and other miscellaneous categories. Similarly, New Zealand has seen a rise in reports of ‘no religion.’ New Zealand cen- sus data showed a rise from 30% in 2001 to 35% in 2006. A general decrease in identification is also indicated (Australian Bureau Social Trends, 2013).

This trend, however, does not suggest that attention to spirituality is unnecessary in Australia and New Zealand. The growth of other religions such as Islam, Hin- duism, and Buddhism points to a need to address spirituality. Also, there is a need to address the spiritual needs of Aboriginal and Maori peoples. Cultural sensitivity to their belief system, which emphasises the importance of body, land, and spirit, is

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critical (Slattery, 1987). Despite cultural, geographical, and linguistic differences between Aboriginal and Maori peoples, both belief systems are holistic and view life as infused with spiritual energy (Tse, Lloyd, Petchkovsky, & Manaia, 2005).

Changes in the spiritual landscape of Australia and New Zealand call for exploring the impact of these shifts and integrating spirituality in family therapy. While it is not in the scope of this article to provide information on the former, it will tackle the latter, describing approaches to integrating spirituality in family therapy, which the author believes lend themselves to an inclusive approach in training family thera- pists to address spirituality in the lives of clients.

Landscape of Spirituality in Marriage and Family Therapy Training

Increasingly, family therapy literature explores the role of spirituality in training mar- riage and family therapists (MFTs). The growing importance of student feedback in education makes it essential to understand how family therapy students view spiritual- ity. In a study by Prest, Russel, and D’Souza (1999), all MFT students said that spiri- tuality was important to consider in clinical practice. Among these students, 76.5% indicated that spirituality was a force in a family therapy career, while 54.9% said it was a strong factor. Furthermore, 72.6% of students indicated that it was desirable to receive supervision and training around spiritual issues. Furthermore, 52.9% believed that it was an important component to include in training programs. At the same time, 92.2% of students said they had not received this kind of training.

Following up on research by Prest et al., another group of marriage and family therapy graduate students, were surveyed. One piece queried students as to whether they had taken a course in their training that focused on integrating religion/spiritual- ity in family therapy; 81.4% of students had not had such a course. Forty-six percent of those students indicated they thought such a course was important and wanted to learn more in this area (McNeil, Pavkov, Hecker, & Killmer, 2012).

In another study by Young et al. (2002) which surveyed 94 marriage and family therapy programs, 69% of respondents reported that their programs addressed spiri- tual and religious issues. Missing from this study is whether the programs taught stu- dents the ‘how’ of integrating spirituality into family therapy practice. Of these respondents, only 46% indicated that they were competent (Young et al., 2002). Utilising spirituality in graduate training programs is understood by some scholars as a critical component of family therapy training (Grams, Carlson, & McGeorge, 2007; Patterson, Hayworth, Turner, & Raskin, 2000). Historically, training programs have included some tools such as the spiritual genogram (Wiggins, 2001). Less developed areas focus on ways of addressing spirituality in supervision. Four areas of supervision where spirituality may emerge are: (1) the client system; (2) the supervisory system; (3) a diversity lens; and (4) lenses of meaning and values (Miller, Korinek, & Ivey, 2006). Exploring the CTS Master of Arts in Marriage and Family Therapy (MAMFT) program will uncover some aspects of these four areas of supervision that exist across the curriculum.

Context of the Christian Theological Seminary Training Program

Christian Theological Seminary (CTS) is a fully accredited ecumenical seminary affili- ated with the Christian Church (Disciples of Christ) in Indianapolis, Indiana. It offers

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eight graduate-level degree programs, including theology, ministry, and counselling, with specialisations in ministries that emphasise the arts and programs for lifelong learning. On the theological spectrum, it espouses a liberal progressive message and is a welcoming and affirming institution for the LGBT community. Students and fac- ulty who represent more than 30 denominations represent a wide spectrum of reli- gious and spiritual beliefs, including Pentecostals, evangelicals, mainline Protestants, Catholics, Jews, individuals who are ‘spiritual but not religious,’ and a few who self- identify as atheist/agnostic.

The Seminary has a history of utilising spirituality as a foundation for training marriage and family therapists. The original program was started with a grant from the National Institutes of Health (NIH) in Washington DC that promoted training for family therapists working with clergy in the 1980s. In 1989, the CTS MFT pro- gram was accredited with the Commission on Accreditation for Marriage and Ther- apy Education (COAMFTE). The MAMFT at CTS is also offered as a dual degree option with the Master of Divinity. The program has 30 students, 38% of whom are persons of colour.

Components of the Program

Between 2005 and 2007, the CTS MAMFT program was selected as one of eight programs across the USA to participate in the American Association for Marriage and Family Therapy (AAMFT) MFT Core Competencies Beta Test Group. Its purpose was to improve effectiveness in teaching the MFT Core Competencies of 2004. These competencies were developed to define ‘the domains of knowledge and requisite skills . . . that comprise the practice of marriage and family therapy . . . to improve the qual- ity of services delivered by marriage and family therapists (MFTs)’ (MFT Core Com- petencies, 2004).

Participating in this group gave our program important motivation to slowly introduce outcome measures. Thus began various methods of soliciting feedback from faculty, supervisors, students, and graduates on the effectiveness of different aspects of the program. Our immediate motivation was an upcoming site visit for COAMFTE in 2012.

While developing our Student Learning Outcomes, we looked more intently at the ways we addressed spirituality in the training program. In meetings with faculty and students, we determined that more points of intersection between spirituality and MFT theory/practice were desirable. The following description of the training pro- gram is the result of these conversations and changes over the last two years.

Methodological Considerations in Integrating Spirituality

Several concerns must be considered when integrating spirituality in a family therapy training program. Some researchers contend that our clients’ religiosity is widely over- looked. The therapist must always respect the ethic of allowing the client’s religious autonomy (Stander, Piercy, Mackinnon, & Helmeke, 1994). This objective, however, can be blocked if knowledge of religious constructs is beyond the therapist’s expertise. However, the therapist’s expertise is not the only important dimension of integrating spirituality in family therapy. The therapist who works with a religious client needs to have first addressed his or her own religious dilemmas. (Stander et al., 1994).

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These considerations are critical when thinking about integrating spirituality into a family therapy training program. They must be added to the usual examination of students’ biases regarding culture, race, gender, and sexual orientation. A critical recognition for students in training programs as well as their clients is that religion or spirituality can both help and hinder therapeutic growth. Some religions may have rigid beliefs that block productive growth. Similarly, some spiritualities may have an amorphous belief system that lends little substance to the lives of students or their clients.

Thus it becomes necessary for family therapy training programs to seriously address the ways in which religion and spirituality heal and hinder both students and clients. Bolstering this dimension of family therapy training programs will strengthen existing standards for accreditation of family therapy programs. The Australian Associ- ation of Family Therapy Document for the Accrediting of Training Programs states: ‘Integrating and understanding human diversity including culture, gender, age, ability, class, religion and ethnicity is a core content area’ (Australian Association of Family Therapy, 2012).

Marriage and Family Therapy Core Competencies emphasises ‘integrating and under- standing human diversity including culture, gender, age, ability, class, religion and ethnicity’ (American Association for Marriage and Family Therapy, 2004). These core competencies are often used as guidelines for MFT programs accredited by the Com- mission on Accreditation for Marriage and Family Therapy Education, which is affili- ated with the AAMFT.

Genograms are widely recognised in family therapy practice as a helpful instru- ment to explore issues regarding diversity concerns. Identifying multiple diversity con- cerns on the same genogram enables the therapist, client, and trainee to gain an overall perspective of the family and cultural impact on the client. Bolstering the spir- itual aspect of the genogram in such work strengthens a readily accessible tool for integrating spirituality in family therapy. Such an approach can be seen in the work of various scholars (Haug, 1998; McGoldrick, Gerson, & Petry, 2008; Wiggins, 2001).

Clearly, the desire to integrate spirituality into family therapy training is supported by these two guidelines used for accreditation. The next consideration is how to do it. Stander et al. (1994) suggest four essentials for integration: (1) use culture as a framework, (2) balance both religion/spirituality and ethics, (3) integrate religion/spir- ituality in ethics and professional studies courses, and 4) address issues evolving out of relationships of clients, therapists, and religious communities.

In looking at spiritual integration, it becomes clear that including some specific content regarding spirituality is important. Just as race, class, and gender have core content, so does spirituality. Different approaches exist for including this important content. A course that specifically addresses spiritual integration with family therapy offers a constructive way forward (Patterson et al., 2000). Collaboration with clergy is offered as an opportunity for both clergy and family therapists. Clergy have limited training around mental health issues. The reverse is also true, in that family therapists rarely receive training around religious issues. Having MFTs train clergy and theologi- cally trained persons to consult with family therapists presents collaboration rarely undertaken (Weaver, Koenig, & Larson, 1997).

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Methodological Considerations in a MFT Training Program

These methodological considerations provide a springboard for explicating the broad methodology used in the MFT training program at CTS. Two core presuppositions are at the core of the curriculum. We believe that well-trained family therapists are both ‘spiritually sensitive’ (Stander et al., 1994) and ‘spiritually literate’ (Haug, 1998).

In this context, ‘spiritual’ applies to theistic and non-theistic belief systems. The institutional ethos focuses on a liberal, progressive Christian perspective that is ecu- menical in outlook. Interfaith conversations occur through special events and espe- cially at the Desmond Tutu Center for Peace, Reconciliation, and Global Justice, a joint collaboration between CTS and Butler University. In addition, classes focusing on world religions are offered. The primary spiritual emphases at the Seminary include Protestant, Catholic, Jewish, Muslim, and ‘spiritual but not religious.’ In addition, aspects of Buddhism are emphasised throughout the curriculum. A certifi- cate in Yoga, Spirituality, and Wellness is offered as well as mindfulness skills taught in the MFT program. We understand that religions and spiritualities have the capac- ity to both help and harm.

The foundational emphases of training spiritually competent and spiritually sensi- tive family therapists rest on balancing immanence and transcendence, constructs that drive lively dialogue between family therapy and spirituality (Anderson & Worthen, 1997; Berenson, 1990; Cook, 2013; Coyle, 2009, 2014; Fukuyama & Sevig, 1999; Gibson, 2001; Jenkins, 2006; Jernigan, 1984; Lartey, 2003; Rothman, 2009). Imma- nence and transcendence are understood in different ways. Some scholars define immanence as the human or secular context, while transcendence refers to the divine or sacred context. Still other understandings see transcendence as too inaccessible, pre- ferring immanence with its human accessibility.

Spirituality that is integrated into the CTS training program sees the boundary between immanence and transcendence as too arbitrary. Immanence and transcen- dence are understood as two interacting boundaries of spirituality as it informs the human condition. The meaning that our trainees’ families seek can be enriched by immanence and transcendence. Through immanence, families seek to improve their connections with one another and in doing so, experience greater closeness. This closeness gives spiritual richness to everyday life. As family members experience a spir- itual connection to one another, they become better able to expand beyond them- selves into the transcendent. This transcendence can be a belief in God, the goodness of the earth, or serving others. So, in this program, spirituality is not an either/or, but a both/and: immanence and transcendence.

Immanence and transcendence are conceptualised on a spiritual continuum. In the program we understand this spiritual continuum to be related to the concept of iso- morphism in systems theory. This means that a thick spiritual experience involves immanence and transcendence, mutually informing each other. It becomes important for our trainees to understand spirituality in a broader sense than is sometimes explained. Such an understanding is part of their professional development in the program.

This spiritual dimension of the trainees’ professional development is nurtured throughout the program as part of a broad multicultural emphasis on diversity. Diver- sity of race, ethnicity, class, culture, age, gender, sexual orientation, religion,

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spirituality, and ability are lifted up as larger systems that impact families. As one lens of diversity, spirituality helps or hinders the growth of families.

Integrating Spirituality in the Training Program

To expand spirituality’s place in the training program, we drew on feedback from our communities of interest and a Seminary-wide curriculum revision initiative. Our spiri- tuality focus now includes five components: foundational religion courses; a course integrating self, system, and spirit as it integrates spirituality into clinical practice; a professional formation cohort group; live supervision focusing on spirituality; and the final Capstone project. Undergirding these components is a curricular emphasis on personal belief and values, theoretical understanding, and skills development. The concept of spirituality woven through these components has a transcendent quality that is rooted in the immanence of the present and embraces the future.

The program’s first component concentrates on foundational religion courses. The revised curriculum went from four required courses in religion to three: biblical inter- pretation; theological reflection; and an elective in ‘Christianity and Culture,’ which includes courses in world religions; the sociology of religion; urban studies; and social justice.

The second component is a course integrating spirituality into clinical practice. This course, ‘Integration of Self, Systems, and Spirit,’ focuses on ways of integrating spirituality/theology with systemic practice and will later be described in detail.

The curriculum’s third major component utilises supervision groups to enable stu- dents to reflect critically on their own spirituality and ways in which it intersects with their clients’ spiritualities. One such group experience is called ‘Spirituality—Profes- sional Formation Cohort Group,’ which focuses on how their own personal spiritual- ity connects to their work with clients. This group emerged over the years from a collaboration that took Harry Aponte’s person of the therapist (POTT) work as a starting point (Aponte & Carol Carlsen, 2009).

The fourth component addresses spirituality in live supervision. A theologically trained supervisor facilitates student feedback around spirituality. After a live session, a student therapist comes to the observation room to reflect with peers and the supervisor. The supervisor’s prompt might be: ‘What spirituality comes forth for you in the session?’ Students respond as the supervisor encourages comments. Another approach focuses on the supervisor leading students in post-session discus- sion using the prompt: ‘What spiritual themes can you name?’ This presents an opportunity for students to recognise themes such as hope, isolation, or forgiveness, which are to be discussed in emotional and behavioural contexts. Continued discus- sion of this question begs deeper exploration of the particular theme as it relates to spirituality.

The fifth component of the spiritually focused curriculum is the Capstone presen- tation, which will be fully described later. It requires students to select a couple or a family, whom they describe through a case conceptualisation, clinical assessment, and treatment plan. Clinical documentation is supported by videos of therapy sessions. Students then integrate spiritual/theological reflections with the clinical case. I now turn to descriptions of the ‘Integration of Self, Systems, and Spirit’ integrative course and the final Capstone presentation to highlight some approaches to integrating spiri- tuality into the curriculum.

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Description of ‘Integration of Self, Systems, and Spirit’

The course begins with reading, lectures, and class discussions about self of the thera- pist. Students are required to submit a ‘Statement of Self’ paper in which they reflect on who they are and their stage of personal and professional development. After forming this basis, the course focuses on overall views of systems as they influence family therapy. At this juncture in the curriculum, students have gained an under- standing of family therapy’s major models. The text for this section of the course is Smith-Acu~na’s (2010) Systems Theory in Action: Applications to Individual, Couple, and Family Therapy.

Then the class shifts focus to theological/spiritual reflection. Students are required to read a book about a type of theology or spiritual practice, or by a particular the- ologian or spiritual author, making this selection in consultation with the professor. Students of varying religious/spiritual preferences have an opportunity to delve into reading that supports their own spirituality. Choices can range from a traditional account of Christian, Jewish, Buddhist, or Hindu teachings and culture to a text about spirituality and the environment, for example.

Throughout the three foci of the course – self, systems, and spirit – students write a brief reflection paper.

The course’s final two assignments seek to integrate the foci of self, systems, and spirit. First is a methodology of integration paper. Students submit a paper that demonstrates their own method of integration. The professor assigns the same clinical case vignette to all students. Students respond to the case vignette by: 1) selecting a model-based or integrative family therapy approach that fits the worldview expressed in the Statement of Self Paper; and 2) selecting a specific theology/spirituality, or the- ologian/spiritual author that was read during the class section on spirit. These are woven together to illustrate the student’s own method of integrating self, system, and spirit.

The last assignment focuses on the student’s experiential approach to integrating self, systems, and spirit. Students are to present a creative arts project that illustrates challenges they encountered in the methodological integration of self, systems, and spirit. This can take the form of an individual or group project. Students, for exam- ple, might perform a skit, present a relevant work of art, compose music, or draw on a combination of sources. They are encouraged to evoke the transcendent, creative side of themselves to contribute to a spiritual experience.

Description of ‘Capstone Presentation’

Students meet in a supervision seminar group: ‘Self, Systems, and Spirit,’ which offers preparation for writing the theological/spiritual reflection and systemic practice paper.

Students consult with peers, a supervisor, program director, and a non-counselling faculty member. At the beginning of the seminar, students select a couple, or a fam- ily, to write a case conceptualisation and clinical assessment. Then students select clin- ical vignettes that represent early, middle, and late stages of treatment. This phase of ‘Self, Systems, and Spirit’ is carried out in close consultation with the student’s supervisor.

Consulting with the program director, students then select a non-counselling fac- ulty member who teaches theology at the Seminary. This person serves as a member

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of the evaluation team, alongside the program director and clinical supervisor. The non-counselling faculty mentor addresses theological/spiritual reflection while the supervisor deals with systemic practice, and the program director tackles the integra- tion of theological/spiritual reflection into systemic practice.

As consultation continues with all mentors, the student presents their case in the ‘Self, Systems, and Spirit’ seminar. All integrative papers must include three elements: self of therapist concerns; systemic theory/practice; and theological/spiritual reflection. The student is responsible for identifying ways that these concerns are connected to belief and value systems.

The program encourages students to explore their views about life and the world at length. In turn, they seek a theoretical orientation that is a good fit with that worldview. Undergirding this approach is an implicit understanding that one’s world- view includes those beliefs, values, and relationships that inhabit spirituality. The pro- gram’s philosophy is that engaging clients in a transformative process demands that therapists understand themselves so that they can best serve others.

Prior to the Capstone Presentation, the student invites the non-counselling faculty mentor to the seminar. The student presents 10 minutes of clinical video clips from a session to give the group a feel for the therapist and client. Then the student provides a five-minute overview of the client’s demographics and clinical themes. With clinical themes highlighted, the student, faculty mentor, and peers discuss the spiritual dynamics of the case. The program director responsible for the integration facilitates conversation. This seminar discussion gives the student a preview of the Capstone Presentation. It also offers a context in which ideas for writing the paper can emerge.

Impact of Integrating Spirituality on Students and Supervisors

Students and supervisors have offered feedback on their experiences in this training program. In a recent interview, one supervisor, a program alum, commented: ‘Spiritu- ality is what drove me to the MFT program.’ She also discussed the interweaving of self of therapist and diversity, which enriches the spiritual emphasis at CTS. Her description of spirituality is expansive: ‘Intertwined with our emotional, mental, and spiritual well-being.’ I asked about her connection to spirituality as a therapist and supervisor. ‘I always bring a spiritual perspective into the room,’ she replied. ‘But it isn’t always overt.’

Students understand self of therapist concerns as a critical dimension of a broader spirituality. One student described addressing self of therapist concerns as an avenue for deepening spirituality. She said that understanding herself laid the groundwork for opening her spirituality to clients. This student saw her own pain as a conduit of care for others: ‘I think it’s basic for me to concentrate on my own wounds . . . in the same way as Nouwen’s The Wounded Healer.’

Another student mentioned that cohort groups were instrumental for enabling her to be more understanding of her clients and others. She said: ‘I find myself having this problem of accepting certain things about people. Then, I was able to learn things about myself.’ Through this increasing self-awareness, she added, ‘I used to think there was only one true religion . . . Now, I know all of us are spiritual beings.’

As students move through these cohort groups, they sometimes experience signifi- cant spiritual changes when they graduate. This was the process for one conservative Protestant student who believed that homosexuality was wrong and sinful. By the end

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of the program, however, he had become an LGBT ally and began taking difficult stands against his church. ‘As I moved through the program,’ he noted, ‘I began to see my LGBT clients’ pain. I asked, “Does God care about this person?” The answer was “yes” and I was changed.’ Most students become more religiously liberal, but some become more religious, even evangelical, and see faith as a leading aspect in life. One student commented: ‘I didn’t see God as even relevant. By the end of the pro- gram, I understand myself and my limitations as part of who God loved.’

Implications for Other Training Settings

We have explored methods for integrating spirituality in a training program at CTS. This setting, however, is unique in that it is nested within a seminary, where spiritual- ity and theological reflection are core components of the curriculum. Furthermore, it belongs to an academic setting where the program is accredited by COAMFTE, which demands adherence to basic marriage and family therapy principles. Training situated in a secular university or an agency without support to encourage the integra- tion of spirituality presents challenges. What follows are some contextualised sugges- tions for integrating spirituality into training MFTs.

1. Develop an overarching emphasis on diversity that recognises spirituality as equally important to other diversity concerns

The first step is to define spirituality as practiced in the training context. This involves collecting feedback from trainees, supervisors, and instructors. As a dimen- sion of diversity, spirituality is often implicit in the clients’ culture. For example, an agency that serves a significant number of Aboriginal peoples would need to integrate the holistic nature of that culture into the agency’s definition of spirituality. An aca- demic training centre would be responsible for addressing a variety of spiritualities to adequately train students.

The next step is to engage supervisors and instructors in brainstorming to come to a consensus about the purpose of training students in spirituality in that particular context. Either concurrently or after this process, it is important to engage students in a similar process.

As the two groups determine the purpose of spirituality in the training program, reflection can begin about what spirituality really is. Brainstorming begins anew as participants in the trainer group and trainee group come up with a definition of spiri- tuality. A creative way to begin the process is to have a ‘round robin,’ where each per- son shares a word that comes to mind when hearing the term ‘spirituality.’

The final step is to create a document that sums up both discussions. Each partici- pant reviews the document individually and makes notes that describe what he or she thinks is important. One person collects this information and edits the comments into one document that clearly defines spirituality. Then, feedback from group mem- bers shapes the final document.

2. Utilise story-sharing in the training context to identify everyday experiences that are spiritually rich

Enriching spiritual experiences includes both the ground-shaking and more common, or mundane, moments. As trainers and trainees reflect on spirituality, it is important to recognise everyday experiences. Participants in the training program can participate

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in the following steps to richly describe formative spiritual experiences. A formative spiritual experience is any experience that connects one to that or who is beyond you or personal relationships. It is an experience you are certain about, beyond any doubt.

Discovering Your Formative Spiritual Experience. (1) Jot down some experiences that come to mind. (2) Note briefly the themes present in each experience. (3) Name them as chapters. (4) Identify what spiritual experience you want to story to yourself. (5) Write or record your story.

Telling Your Spiritual Story. (1) What qualities does this story emphasise for you? (2) What individuals have a relationship with you through these spiritual qualities? (3) To which places do these qualities transport you? (4) What spiritual fruits draw you closer to God, or that which is larger than you?

Spiritual Practice – Reflecting on Your Spiritual Story. (1) How does this spiritual story support you? (2) How do your spiritual stories affect you now? (3) What does the story awaken in you?

Responding to Your Spiritual Story. (1) What do these everyday challenges emphasise for you? (2) How do your everyday spiritualities move you to sacred concerns? (3) What connects with you in this re-storying of faith? (Coyle, 2013; http://spiritualnar ratives.com)

3. Identify theologically/spiritually trained professionals in your community to serve as consultants

Spirituality, like marriage and family therapy, includes a body of literature and cre- dentialling that qualify professionals in this field. Integrating spirituality into a train- ing program demands that components of the integration method are informed by rigorous study and training. As family therapists, we would not expect another profes- sional to be able to teach marriage and family therapy simply because the individual is married or has a family. Similarly, one’s personal spirituality is not sufficient for the MFT trainer to be automatically equipped to know how to integrate spirituality into clinical practice.

Training programs nested in secular universities can engage with colleagues in the university’s religion department to create interdisciplinary conversations. If the univer- sity does not have a religion department, the family therapy program might contact colleagues at a religiously affiliated university to explore options for cross-institutional conversations. Agency training programs can explore similar possibilities.

Other resources for academic and agency-training programs can be found within the community. Religious leaders in the Jewish, Christian, Hindu, Buddhist, and Muslim communities are often quite open to conversations with mental health profes- sionals. This opens possibilities for referrals to family therapists, since many individu- als first contact clergy or religious leaders when faced with personal or family distress.

Still, other possibilities exist. Yoga instruction is now common in metropolitan areas. While not all yoga instructors are trained in its spiritual dimension, many are. It would be advisable to determine an instructor’s level of familiarity with spirituality. Also, many communities have spiritual directors. These persons are often connected

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to a Catholic religious community or parish. Another possibility is to engage in mind- fulness, as led, for instance, by a Buddhist practitioner.

4. Utilise technology in partnering with family therapists who have training in spiritual and theological disciplines

Technology affords universities and agency-training programs possibilities for connect- ing with family therapists across vast expanses. These training programs can be used to reach out to persons with spiritual/theological training through videoconferencing. One option is to set up a conference with students and the consultant. Students would send a video or case report of a clinical session to the consultant before the teleconference, to receive feedback and engage student/supervisor participants in a reflective conversation. Transcripts of the session would then be sent to all participants.

A university, agency, or professional family therapy organisation could also hold a webinar featuring family therapists with specialised training as keynote speakers. Par- ticipants could then ask questions at the webinar. Universities might also offer online courses that integrate webinars in the overall curricular structure of a course that inte- grates spirituality into family therapy.

5. Look at the constructs of immanence and transcendence as practiced throughout the whole program

Begin to think of spirituality as a continuum that includes both immanence and tran- scendence. Keeping spirituality inside a silo ensures that it will be extinguished. The context of a training centre is to encourage creativity and discipline. Thinking of these constructs as enveloping the whole enables both trainers and trainees to discover spiri- tuality within and between each other.

Future Exploration

Integrating spirituality in family therapy training can be greatly enriched by asking challenging questions. How can respect of individuals’ spirituality have coherence for the whole trainee group? How do cultural considerations impact the integration of spirituality into training? How can a spirituality of the everyday through immanence and a spirituality of what lies beyond through transcendence be more clearly articu- lated in training?

Integrating spirituality into family therapy training programs has the potential to enrich family therapy with clients of various spiritualities and cultures. By becoming spiritually literate and spiritually sensitive, trainees can bring the spiritual dimension into their total consideration of diversity as the foundation for families to thrive.

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