Biopsychosocial Spiritual Assessment
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Spiritual_Assessment_Handbook_for_Helping_Professi..._----_Pages_76_to_100.pdf
ACCESSING MARITAL AND FAMILY SPIRITUALITY 75
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76 SPIRITUAL ASSESSMENT: A HANDBOOK FOR HELPING PROFESSIONALS
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ACCESSING MARITAL AND FAMILY SPIRITUALITY 77
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Hodge, D. (2003). Spiritual assessment : Handbook for helping professionals. North American Association of Christians in Social Work. Created from liberty on 2026-02-11 01:35:32.
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CHAPTER FIVE
Spiritual Genograms: A Generational Approach to Assessing Spirituality6
There are a number of reasons for adopting a generational approach for spiritual assessment. Wuthnow’s (1999) ethno- graphic study (N = 200) on religious perceptions led him to con- clude that there are at least three important generational aspects involved in the transmission of spiritual and religious values. First, there is the direct influence that grandparents have with their children and grandchildren in settings where several genera- tions live together in the same household. Second, in situations in which grandparents do not live in the household, they indirectly shape perceptions through the memories they evoke, especially in cases where at least one of the grandparents was noted for piety. Finally, gender differences are also relevant, since mothers and grandmothers frequently play a decisive role in childhood reli- gious experiences.
In most cases, families are successful in passing on their val- ues and beliefs. Bengtson and Harootyan’s (1994) nationally repre- sentative study (N = 1500) on intergenerational linkages found that most respondents felt their opinions were either “similar” or “very similar” to those of their parents. Likewise, O'Connor and associates’ (1999) 24-year follow-up study (N = 206) of religious behaviors and attitudes found that 68% of respondents still self- identified as members of their original denomination.
Conversely, spiritually related issues can be a source of inter- generational conflict. Clarke and associates’ (1999, p. 267) analysis of the Longitudinal Study of Generations data file (N = 1137) found that “religious beliefs were often mentioned as areas of con-
6 Much of the material in this chapter appeared previously in an arti- cle written by D. R. Hodge entitled, Spiritual genograms: A generational approach to assessing spirituality (2001). Families in Society, 82(1), 35- 48.This material is used in this book with the permission of the Families in Society.
Hodge, D. (2003). Spiritual assessment : Handbook for helping professionals. North American Association of Christians in Social Work. Created from liberty on 2026-02-11 01:35:32.
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SPIRITUAL GENOGRAMS 79
flict.” An adult child may, for example, experience a spiritual awakening, leave her parents’ denomination that was perceived to be spiritually lifeless, and join a new denomination that is per- ceived to be more spiritually alive.
To summarize, while the individualistic perspective makes an important contribution, each person is imbedded in a particular family structure. Family-of-origin continues to inform beliefs and experiences, regardless of whether individuals negotiate a place for themselves within their family’s tradition or exercise their right to convert to another faith tradition. Thus, it is important to develop generationally-based assessment procedures that are more congruent with the person-in-environment approach that has traditionally informed helping professions such as social work. A modified version of the traditional genogram would seem to present an ideal vehicle for this task. Traditional genograms are widely used and have been adapted to serve a number of discrete uses (McGoldrick, Gerson & Shellenberger, 1999).
A spiritual genogram is an assessment instrument specifically designed to identify and operationalize the spiritual and religious strengths that exist in clients’ family systems. Charting the family
The first step in constructing a spiritual genogram is to de- lineate the basic family structure over three generations (Frame, 2000a). Grandparents, parents, aunts, uncles, cousins, siblings, nieces and nephews are depicted, along with significant dates, such as births, marriages, divorces, remarriages, and deaths, as in a typical genogram. Some practitioners may also find it helpful to symbolize the quality of the relationships, noting conflict, close- ness, distance, etc. McGoldrick, Gerson and Shellenberger (1999) and Stanion, Papadopoulos and Bor (1997) provide, respectively, book and article length overviews of basic genogram construction.
Family members, however, are not the only actors in a cli- ent’s spiritual history. Indeed, many religious traditions conceptu- alize themselves as a form of spiritual, as opposed to biological, family. Consequently, there may be distantly related or even unre- lated individuals who played a role of spiritual import equal to any person in the client’s immediate constellation of relatives over the course of time (Hardy & Laszloffy, 1995). These individuals can also be listed on the spiritual genogram (Bullis, 1990). Thus, to supplement the traditional squares representing males and circles denoting females, triangles can be used to designate individuals
Hodge, D. (2003). Spiritual assessment : Handbook for helping professionals. North American Association of Christians in Social Work. Created from liberty on 2026-02-11 01:35:32.
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80 SPIRITUAL ASSESSMENT: A HANDBOOK FOR HELPING PROFESSIONALS
who have played major spiritual roles but are not members of the immediate biological family.
Color Coding Denominational Affiliation and Religious Preference Drawing pencils of various hues can indicate clients’ spiritual
orientation, their spiritual and religious beliefs or spiritual cos- mology, on the basic genogram (Lewis, 1989). Color coding pro- vides a graphic “color snapshot” of the overall spiritual composi- tion of clients’ families, which in turn suggests a variety of initial hypotheses about clients’ present spiritual reality (Hardy & Laszloffy, 1995). For example, a couple’s spiritual genogram that consists of a single color on one side and is multicolored on the other can highlight contrasting spiritual orientations.
More specifically, the square representing a grandfather who was a devout Southern Baptist could be colored red while the cir- cle depicting his wife, a member of the Assemblies of God, might be colored orange. Similarly, a son who is a Muslim might be col- ored brown and his Roman Catholic wife green. Other colors can be used to mark different denominational affiliations or religious preference (e.g., Presbyterian-blue, New Age-purple, Athe- ist/secular-black, etc.). If denominational affiliation and religious preference is unknown, then no color is used.
A person who converts to another religious tradition or de- cides to change denominational affiliations can be depicted by marking in the appropriate color in a circle around the outside of the figure representing the person. The date of the change should also be listed on the genogram beside the symbol in brackets. This provides an indication of the stability or fluidity of affiliation over time (Frame, 2000b).
The line connecting the parents to the children can be color coded based upon the denomination or religious tradition in which the children were raised. Additional colors can be em- ployed if changes occurred during childhood. Building on the above example, a son that was raised in the Islamic tradition until the death of his father at age 10 and was subsequently raised Catholic would have a brown line that changes into a green line running from the parents to the child. The date of the change at age 10 could be recorded on the spiritual genogram at the point where the line changes color from brown to green.
Hodge, D. (2003). Spiritual assessment : Handbook for helping professionals. North American Association of Christians in Social Work. Created from liberty on 2026-02-11 01:35:32.
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SPIRITUAL GENOGRAMS 81
The Limitations of Affiliation While most clients are affiliated with a particular denomina-
tion (Gallup & Lindsay, 1999) and remain in their family of ori- gin’s denominational affiliation (O'Connor, et al., 1999; Gallup & Lindsay, 1999), there is growing realization that denominational affiliations are often inaccurate indicators of adherents’ beliefs (Clydesdale, 1999). Due to what Hunter (1991) refers to as an epis- temologically based religious restructuring, denominational af- filiations, and even religious preference to some extent, are grow- ing less significant as indictors of personal spiritual orientation (Hoffmann & Miller, 1998; Sullins, 1999).
As Hunter (1991) observes, many denominations incorporate both orthodox believers, who affirm a transcendent timeless un- derstanding of truth, and progressive adherents, who believe that truth evolves as dictated by the spirit of the present age. Thus, de- nominations are frequently split to some extent along epistemo- logical lines, with some churches affirming an orthodox or conser- vative understanding of truth, while others hold a progressive or liberal view. Put differently, due to differences in epistemology, clients can express their spirituality in radically different manners even when members of the same denomination.
As a result of this religious restructuring, epistemology rather than denomination is becoming an increasingly salient marker of one’s metaphysical worldview. Due to what Hunter (1991) calls an “ecumenism of orthodoxy,” an evangelical United Methodist, a charismatic Episcopalian, and a traditional Catholic may have more in common with each other than members of their own de- nominations, in spite of significant theological differences that might have hindered such relationships in past generations. Simi- larly, although to a lesser extent, a devout Hindu, Muslim, or Or- thodox Jew may have more in common with a Mormon, due to their shared epistemological approach, than members of their own traditions whose beliefs have been largely secularized by the dominant progressive culture (Fenton, 1988; Smith, 1999; Wuth- now, 1999).
Consequently, an executive who holds an evangelical Chris- tian spiritual orientation might switch denominations with each corporate move, selecting a church with an orthodox understand- ing of truth. In situations where clients have repeatedly changed denominations, it may be appropriate to discard denominational affiliations entirely when color coding. In addition to depicting the
Hodge, D. (2003). Spiritual assessment : Handbook for helping professionals. North American Association of Christians in Social Work. Created from liberty on 2026-02-11 01:35:32.
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82 SPIRITUAL ASSESSMENT: A HANDBOOK FOR HELPING PROFESSIONALS
major religious traditions, such as Islam, Buddhism, Hinduism, secularism, etc., color coding might be used to portray the major epistemologically based traditions within Christianity: evangelical Christianity, liberal/mainline Protestantism, and traditional and liberal Roman Catholicism.
Similarly, when working with individuals from other major religious traditions, a similar epistemological demarcation often exists between orthodox believers on the one hand and progres- sive and secular/cultural adherents on the other. For instance, Fishbane (1999) notes that many individuals now consider the Jewish community to be two separate communities, with the rift so great that Orthodox Jews are unable to sanction their children marrying liberal Jews, who may not be considered Jewish accord- ing to traditional rabbinic law.
Integration and Client Selection It is not uncommon for both denominational and epistemo-
logical approaches discussed above to ring true in clients’ experi- ence. In such situations, both methods may be incorporated into the genogram by dividing the symbols diagonally in two, with the left half designating the denomination and the right half the epis- temological status. For example, while both parents may belong to the same Southern Baptist denomination as their daughter, the cli- ent may view her mother as a conservative and her father as a lib- eral. In this case, the right side of both symbols would be colored red, while the left side of the mother’s circle might be colored yel- low, to signify conservative beliefs, and the right side of the fa- ther’s square is colored gray, to indicate liberal beliefs. Similarly, yellow and gray would be used with other individuals in the genogram to indicate orthodox and progressive spiritual orienta- tions, with an additional color being used to depict other orienta- tions if warranted in the client’s perception (e.g., pink might be used on the left side of the symbol to portray a nominal, essen- tially secular Southern Baptist).
It is important to ensure that the religious preference and de- nominational affiliation accurately represents clients’ phenome- nological reality. As mentioned above, the essential point of color coding is to reflect the degree of spiritual and religious congru- ence and dissimilarity that exists throughout the family system. Accordingly, practitioners may wish to explain the basic concepts to clients and allow them to select the colors that most accurately
Hodge, D. (2003). Spiritual assessment : Handbook for helping professionals. North American Association of Christians in Social Work. Created from liberty on 2026-02-11 01:35:32.
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SPIRITUAL GENOGRAMS 83
reflect their perceptions in a manner that serves as a good proxy for their spiritual orientation. While religious preference and de- nominational affiliation provide good starting points, particularly for grandparents, practitioners should seek to move beyond these initial markers to obtain a fuller understanding of how spirituality was expressed in the family system, with clients making the final determinations.
Filling in the Picture Significant spiritual events should also be recorded on the
genogram. Baptisms (water and spirit), confirmations, church memberships, bar and bat mitzvahs, and other events that hold re- ligious import can be included (Frame, 2000b). When possible, symbols drawn from clients’ spiritual cosmology should be used to depict these events. For instance, charismatic or pentecostal be- lievers might use a dove to represent the filling of the Holy Spirit while Hindus might draw a relief of a temple to denote the signifi- cant effect the opening of a new temple had on their community. In addition to symbols, short summary statements can be deline- ated on the genogram to note significant events.
Depicting Notable Spiritual Relationships In addition to depicting religious beliefs, it is also possible to
include an affective component as well. Felt spiritual closeness be- tween family members can be illustrated on spiritual genograms. Lines with double-headed arrows can be used to symbolize a rela- tionship in which individuals experience a close reciprocal spiri- tual bond, with the thickness of the line indicating the intimacy or strength of the relationship (Hodge, 2000a). In situations in which the relationship was more hierarchical and less reciprocal, as might occur with a grandparent mentoring a grandchild, a single arrowhead can be used to depict the flow of spiritual resources. Finally, spiritual conflict can be portrayed with a jagged line, simi- lar to a lightening bolt, drawn between the two individuals.
A Case Example Diagram 2 (below) indicates what a relatively straightfor-
ward spiritual genogram might look like for a couple, Mark and
Hodge, D. (2003). Spiritual assessment : Handbook for helping professionals. North American Association of Christians in Social Work. Created from liberty on 2026-02-11 01:35:32.
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D iagram
2
N om
inal Inactive 18-25yrs attender A
ctive 25yrs-- Fred Sarah D
avid Stacy R eggie C
arol Jane
[17]
82
K evin R
achel Frank H annah Sue B
ea K aren
� [21] �
m arried in their early 30s
R uth
Y
outh M
ark A lice pastor B
eth
M arried three years—
frequent m arital conflict
1st
19
�28
�
�
�
vision
Strengths W
orship C
hristian m usic
Prayer B
ible study Experiences of G
od’s love Spiritual biographies
Strengths B
ible study Prom
ise K eepers
Y outh m
entorship
Hodge, D. (2003). Spiritual assessment : Handbook for helping professionals. North American Association of Christians in Social Work. Created from liberty on 2026-02-11 01:35:32.
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SPIRITUAL GENOGRAMS 85
Beth, who are experiencing marital problems. Various patterns (e.g., dots, diagonals, waves, etc.) are employed to depict different denominations in place of the actual colors that would normally be used with a spiritual genogram.
As represented by the dotted “color” coding, Mark’s family system is characterized by a single denominational affiliation, Southern Baptist, with the exception of his maternal grandmother, Stacy, who was a nominal Methodist. While the shared values have helped the family maintain a relatively close, loving bond, Mark has always felt especially attached to his maternal grandfa- ther, crediting David for helping him to turn his life around in his teens when he was experimenting with illegal substances in defi- ance of his family’s standards. David’s mentoring relationship also played an instrumental role in his baptism at age 19, which sparked a full return to active participation in his church . Also noted on Mark’s spiritual genogram is that Kevin, Mark’s father, had difficulty coming to terms with the death of his 82-year-old fa- ther until he received divine comfort in the form of a dream and that David has experienced some spiritual conflict with his wife Stacy over the years.
Beth’s family system exhibits a greater degree of spiritual di- versity. Her paternal grandmother, Carol, was raised Episcopa- lian. However, at age 17 she experienced an infilling of the Holy Spirit at an interdenominational Pentecostal youth rally. She sub- sequently left the Episcopal Church, joining the Assemblies of God, where she met her husband, and raised her four children in that denomination. Although Reggie was only marginally in- volved in his religious community, his involvement with Carol led to a re-engagement with his church. Hannah, the oldest daughter from Reggie and Carol’s marriage, abandoned her faith for agnos- ticism during her college years, a decision that caused a degree of sorrow in the family.
Beth’s parents are both particularly committed Christians, as signified by the open scriptures. Little is known about Beth’s ma- ternal grandmother, Jane, and nothing about her maternal grand- father. Beth’s mother, Karen, experienced a particularly stormy upbringing that lasted into her mid-20s. A spiritual conversion at 28, and subsequent involvement in the Vineyard Christian Fellow- ship, led to a significantly sunnier period in Karen’s life. As indi- cated by the heavy line, Carol has played an important role as a mentor in Karen’s life after joining the family.
Hodge, D. (2003). Spiritual assessment : Handbook for helping professionals. North American Association of Christians in Social Work. Created from liberty on 2026-02-11 01:35:32.
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86 SPIRITUAL ASSESSMENT: A HANDBOOK FOR HELPING PROFESSIONALS
Beth’s parents were heavily involved in church activities and have been accorded a number of honors for their contributions. During Beth’s late teen years, an international mission trip to work with an oppressed desert dwelling population had a significant in- fluence upon her life, sparking a lifelong sensitivity to social jus- tice issues as she experienced God’s heart for the poor and disen- franchised. While Beth has generally gotten along well with her parents, there have been frequent stormy periods, particularly with her mother. Ruth, her youth pastor, has been a significant spiritual influence in her life. Indeed, Ruth is widely respected in her parents’ church and has played a role as a spiritual mentor with both of Beth’s parents, although the relationship has been re- ciprocal.
Conducting an Assessment Given the sacred nature of spirituality for many clients, it is
important to obtain clients’ consent before exploring the issue. For example, a practitioner might ask Mark and Beth if spirituality feels like an area they wish to explore. Similarly, the spiritual genogram should also be explained and permission secured be- fore initiating construction. The exploration of clients’ spiritual cosmologies should be conducted in a spirit of openness and re- spect which empowers clients to discover their own solutions (Rey, 1997)
Practitioners can safeguard clients’ autonomy by monitoring their own and clients’ responses to sensitive, value-laden issues to ensure that clients are assenting to the movement of the clinical dialogue. Practitioners should be aware that religious counter- transference occurs commonly, particularly when addressing ar- eas in which value systems conflict (Genia, 2000). For instance, feminist practitioners raised in a faith tradition that affirms com- plementary gender roles, such as Mark’s Southern Baptist tradi- tion, may find that clients who hold complementary views on gender relations evoke unresolved emotions that jeopardize the therapeutic relationship (Black, Jeffreys & Hartley, 1993).
Roberts (1999b) suggests that practitioners be sensitive to the biases of the dominant culture toward clients’ spiritual belief sys- tems. For instance, the unfounded media-propagated accusations that Muslims were responsible for the Oklahoma City bombing or, alternatively, Time magazine’s decision not to mention the Col- umbine killers were motivated by anti-Christian hatred in their 20-
Hodge, D. (2003). Spiritual assessment : Handbook for helping professionals. North American Association of Christians in Social Work. Created from liberty on 2026-02-11 01:35:32.
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SPIRITUAL GENOGRAMS 87
page cover story reflect prejudice against these two faiths (Rabey, 2000; Roberts, 1999b). Clients may be more receptive toward shar- ing their personal spiritual narratives if practitioners demonstrate an empathetic awareness of the discrimination people of faith fre- quently encounter at the hands of the dominant secular culture.
Areas to Explore While the construction of a spiritual genogram should be as
client directed as possible, practitioners play an important role by helping clients explore their spiritual history. To assist in the ex- ploration, practitioners should be aware of a number of common patterns that may exist in clients’ histories. While it is critical not to stereotype or generalize regarding spiritual beliefs (Griffith, 1999), it may also be helpful to be aware of some commonly occur- ring themes that may warrant exploration.
While most individuals are religiously active, over three- quarters become inactive during some point of their lives (O'Con- nor, et al., 1999). O’Conner and associates (1999) found that the average age at which inactivity began was 21, with the period of inactivity lasting approximately 7 years. Important life decisions that typically occur during the 20s can come back to haunt indi- viduals when they re-engage their spiritual walk later in life. For example, courtship and marriage may occur when either one or both of the parties are inactive in their faith. Conflict may occur when individuals seek to re-connect with their spiritual roots.
Problems may also arise from differing levels of spiritual and religious involvement, even among denominations that hold gen- erally similar theological views. Baptists, for example, may be much more likely to be spiritually and religiously engaged than Methodists or Catholics (O'Connor, et al., 1999). Accordingly, it is important to explore with the client denominational distinctives and how any differences in denomination or religious preference played themselves out in family life.
In aggregate, the salience of spirituality increases with age (Argue, Johnson & White, 1999). Consequently, grandparents may have an added desire to pass on their wisdom to their families, and close, cross-generational spiritual bonds may arise with spiri- tually receptive grandchildren. Further, in African American, as well as many other minority communities, the role of elders in the transmission of spiritual and religious values may take on a more prominent role (Dancy & Wynn-Dancy, 1994).
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Wuthnow (1999) notes that growing up in a devout home places people in a distinct subculture. Much like individuals who fall under Hunter’s (1991) ecumenism of orthodoxy, these people are often acutely aware that their values, morals, and perceptions differ from those of the dominant secular culture. As Talbot (2000) observes, in the midst of an ascendant secular culture, these indi- viduals represent the new counterculture. Two prominent indica- tors that are associated with this discrete outlook are childhood environments in which one’s parents read the Bible at home and regularly held family devotions (Wuthnow, 1999).
Major life challenges frequently enhance the personal salience of spirituality (Pargament, 1997). Difficulties often serve to re- orient individuals toward an eternal perspective. While crisis can drive people away from God due to perceived lack of help in time of need, they more frequently have the reverse effect, as individu- als seek refuge in the only Being that is able to transcend the cur- rent crisis (Ferraro & Kelley-Moore, 2000).
Table 3 (below) provides practitioners with a list of possible questions that can be used in tandem with the above material to facilitate the exploration and construction of a spiritual genogram. The questions are grouped somewhat thematically, moving to- ward increasing degrees of personal disclosure. Given the highly personal nature of spirituality for many individuals, clients may find it easier answering questions about relatives’ beliefs and prac- tices than their own, at least until a degree of trust has been estab- lished. Concurrently, practitioners should not feel locked into any specific order, nor should the exact wording necessarily be re- tained. Rather, much like the above material, they are offered as a resource to alert practitioners to possible areas of inquiry that can be woven into the therapeutic dialogue to help clients access per- tinent data.
Moving Toward Interventions After the basic historical components of a spiritual genogram
are set in place, it is appropriate to shift from the examination and depiction of past dynamics to highlighting present spiritual func- tioning. The focus shifts from other family members to the client. In this stage of the assessment, practitioners help clients explore how their past spiritual histories have shaped their current spiri- tual functioning. It also sets the stage for shifting toward interven- tions.
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Table 3
Possible Questions to Assist in Constructing a Spiritual Genogram
What type of religious affiliation characterized each member of your family, going back to your grandparents? How meaning- ful was their relationship with their denomination/faith? Their church (house of worship)? To what extent were their personal be- liefs and those of their church/denomination congruent? What was their level of participation? To what extent did they enjoy re- ligious fellowship? Their spiritual lives?
How did they express their spiritual and religious beliefs? What were the particular rituals or sayings that were commonly evidenced? How were spirituality and religion assets in their lives? How did their spirituality intersect with the difficulties they encountered in life? How did their faith help them cope with tri- als?
What spiritually significant events (transi- tions/conversions/changes in affiliations/encounters with trans- personal beings) have occurred in the family? How did these events affect the individuals involved? How did other members react to these changes?
What are the differences (and similarities) among various family members in their beliefs (practices)? How were differences and conflicts managed? Who was the spiritual leader in your fam- ily? What role did your grandparents play in your spiritual walk?
What spiritual relationships stand out to you in your child- hood years? What are your earliest religious memories? Did your family hold regular devotional times? What types of spiritually- based practices occurred at home? Which members of your family have had most influence on your spiritual walk? Who do you feel closest to in a spiritual sense?
Table 4 (below) provides a list of sample questions that might be asked to foster reflection on how past history has influenced
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90 SPIRITUAL ASSESSMENT: A HANDBOOK FOR HELPING PROFESSIONALS
Table 4
Questions that Might Be Used for Transitioning to Interventions
In relationship to your family, what are your current reli- gious and spiritual beliefs? How have your beliefs (prac- tices/feelings) changed since childhood (adolescent)? How has your family’s beliefs and practices affected your present expres- sion of spirituality?
To what extent do you experience conflict (fellow- ship/harmony) with other family members over your spiritual be- liefs? What have you accepted and rejected from your family’s spiritual history? What prompted these decisions?
What sort of patterns do you see emerging over time? How does your present spirituality intersect with these patterns? How has God worked through your family? How has God worked through your family to touch you?
How does your spirituality assist you in dealing with difficul- ties? Are there religious practices that help you cope with trials? Does the severity of your problem(s) dissipate or disappear when you engage in certain spiritual practices? What does your faith teach about forgiveness? How have you been able to apply this teaching in your own life?
Are there spiritual strengths in your family’s history that you could draw upon to help you deal with problems? Are methods of dealing with problems that you might be able to adapt from oth- ers? What sort of insights could you draw from your spiritual genogram that might help you to address your current difficul- ties?
present functioning. Keeping in mind the same cautions as noted in regard to Table 3, these questions generally move from personal exploration toward intervention. Consequently, in the context of the ensuing discussion, an attempt should be made to identify spiritual strengths that can be used to address presenting difficul- ties. Put differently, clients and practitioners should work together to ascertain spiritual resources and how these assets can be
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brought to bear on problems. As the case example illustrates, in- sights can be written on the spiritual genogram.
Interventions While the interventions selected are dependent upon each
client’s unique life context, and the theoretical orientation of the clinician, there are a number of interventions that flow naturally from a spiritual genogram of which practitioners may wish to be aware. As Stanion, Papadopoulos and Bor (1997) record, con- structing and exploring a genogram is a therapeutic intervention that often sparks significant changes. Fresh perspectives and as- sets that clients had previously been conscious of in only a periph- eral sense are brought into concrete relief by their physical depic- tion. In turn, practitioners can build on these developments to so- lidify change.
New narratives can often be fostered as clients see themselves as actors in empowering stories. For example, clients may be able to discern God’s hand in certain circumstances over the course of time. A pattern of God’s personal intervention, previously undis- cerned, may be apparent in the genogram. For example, Mark and Beth’s spiritual genogram clearly depicts God’s intervention in Kevin’s life as well as Carol’s and Karen’s with significant positive ramifications echoing down through the family systems. Instead of seeing themselves as isolated individuals, overwhelmed by life’s circumstances, clients see themselves as under the providen- tial care of God. Disempowering discourses can be altered by such insights, opening up new possibilities to address problems (Richert, 1999).
Working with a Christian sample, Pargament and Brant (1998, p. 122) have identified a number of positive attributions that may help individuals cope with crisis. Table 5 (below) provides a redacted list of these attributions. Practitioners may be able to fos- ter the adoption of positive narratives by highlighting these attri- butions when they appear in clients’ family histories. Similarly, practitioners may want to explore to what extent these attitudes exist during the construction of spiritual genograms when work- ing with Christian clients.
Cognitive approaches using spiritual content have been dem- onstrated to be effective with both Muslims (Azhar, Varma & Dharap, 1994; Azhar & Varma, 1995a; Azhar & Varma, 1995b) and
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Table 5
Positive Cognitive Attributions during a Crisis
Thought about how my life is part of a larger physical force
Worked together with God as partners to get through this hard time
Looked to God for strength, support, and guidance in this crisis
Thought about sacrificing my own well-being and living only for God
Tried to find the lessons from God in the crisis
Looked for spiritual support from my church in this crisis
Tried to give spiritual support to others
Confessed my sins and asked for God’s forgiveness
Asked God to help me find a new purpose in living
___________________________________________________________ Redacted from Pargament and Brant (1998)
Christians (Hawkins, Tan & Turk, 1999; Propst, 1996). Spiritual genograms can be used to detect healthy beliefs that are spiritually based and substitute them for unproductive beliefs in accordance with the standard tenets of cognitive therapy.
Spiritual genograms also afford the opportunity to reconnect with both the spiritual roots and strengths of family members. As Walsh (1999a, p. 43) noted, “restoring vital bonds with a family’s religious heritage is healing and empowering.” For instance, a young African American struggling with racism might benefit from learning how the Christian beliefs of elderly grandparents enabled them to overcome similar problems (Johnson, 1995). Not only is the relational connection empowering but practical strate-
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gies can be gleaned to tackle extant problems. Or to use the case study as an example, Mark may benefit from exploring with his maternal grandfather, David, how to overcome his marital con- flicts in light of David’s own struggles with his wife.
Spiritual genograms may also suggest opportunities to be- come engaged in local fellowships, church bodies, small groups, and other religious communities. Social support can be a key fac- tor in overcoming problems. For example, Maton and Salem’s (1995) longitudinal examination of an evangelical Christian con- gregation revealed an empowering, supportive, strengths-based atmosphere that engendered an increased sense of self-worth, connectedness, and optimism regarding the future. Additionally, religiously-based social support may be qualitatively and quanti- tatively superior to social support obtained in other forums (Elli- son & George, 1994). In the case of individuals who are not cur- rently involved in a religious group, spiritual genograms may re- veal such strengths, perhaps in the lives of other family members, and encourage personal re-engagement with one’s own tradition. Alternatively, sporadic attendees may decide to increase their level of interaction. In the case of regular attenders, such as Mark and Beth, the possibility of untapped resources that might be used to address problem areas can be explored.
Rituals can often be used to address problems. The intensity of problems may be attenuated when clients engage in certain rituals, such as prayer, worship, family devotions, scripture read- ing, music, participation in activities such as Promise Keepers, youth mentoring programs, etc. In solution-based terminology, they often represent a time when “exceptions” from present diffi- culties are experienced. By building on what works in clients’ lives, problems can be overcome in other areas (Kuehl, 1996; Kuehl, 1995). Spiritual genograms can be used to identify current rituals, or those of other family members who have encountered similar problems. For example, a spiritual genogram may reveal a family ritual that fell into disuse after a particular person’s death that could be accessed to address a current problem (Roberts, 1999a).
Finally, there is a growing empirical body of work on the effi- cacy of forgiveness interventions (McCullough, Paragament & Thoresen, 2000). Essentially all major world religions endorse for- giveness as an expression of orthodox faith (Rye, et al., 2000). Spiritual genograms are perhaps the ideal tool to identify con-
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flicted family relationships and tap into the necessary spiritual re- sources to foster healing. DiBlasio’s (1998) article provides a good overview of the use of decision-based forgiveness interventions within the context of intergenerational therapy. It should also be mentioned that many of the practical suggestions DiBlasio lists can be transferred to forgiveness interventions directed toward individuals outside the family unit.
Uses of Spiritual Genograms Although spiritual genograms can be effective instruments in
a number of situations, practitioners may find them to be particu- larly useful when clients present with problems involving family members or family of origin issues. For example, Heller and Wood’s (2000) examination of couples that married individuals from other faiths found that they experienced unique barriers to intimacy that were spiritually based. For these intermarried cou- ples to achieve intimacy levels comparable to those who married within their tradition, the couples had to work through these dif- ferences. As the case example illustrates, spiritual genograms serve as an effective tool to expose areas of difference and poten- tial conflict as well as highlighting the respective spiritual strengths each person brings to the relationship.
Conversely, spiritual genograms could also be used with couples from similar backgrounds to increase their level of inti- macy. Heller and Wood (2000) found that couples who affirmed the same tradition achieved high intimacy levels based upon their shared understanding. Thus, practitioners may find spiritual genograms to be a useful tool for increasing intimacy by further drawing out similarities and then building upon the couple’s commonalties.
Spiritual genograms can also be useful in dealing with recent immigrants from various faith traditions. For instance, Daneshpour (1998) noted that genograms were crucial when working with Muslims due to the sense of cohesion and interde- pendency among family members. In such cases, spiritual geno- grams can highlight spiritual resources, important relationships and other spiritually-based information that is significant for un- derstanding clients and ameliorating their problems.
Poole (1998) noted that genograms may be helpful with His- panics as they show respect for tradition and help connect spiri- tual and religious dimensions to treatment plans. Similarly, they
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may also be particularly useful with other populations that have a prominent sense of extended family and/or where spirituality is an important facet of existence, such as African Americans (Frame & Williams, 1996).
Conversely, spiritual genograms may be an inappropriate as- sessment instrument in some situations. For instance, certain cli- ents may not connect past functioning with present conditions and, consequently, may believe that genogram construction con- stitutes a misuse of therapeutic time (Kuehl, 1995). In such situa- tions, more present focused assessment approaches, such as spiri- tual ecomaps (see Chapter 4) may better suit clients’ desires due to their “here and now” orientation and their relatively rapid con- struction.
Finally, in light of time limitations, many practitioners are adopting techniques drawn from brief modalities. While a number of interventions profiled in this paper are either drawn from or are congruent with brief approaches, readers interested in further in- formation may wish to consult two articles written by Kuehl (1996; 1995). Kuehl provides an extended discussion on the inte- gration of solution oriented approaches and genograms that can be used to supplement the material presented in this chapter.
Conclusion
The strength of spiritual genograms is their ability to reveal generationally informed spiritual conflicts and resources, and to connect clients with those resources to solve problems. For fami- lies and individuals who desire to understand how their religious heritage intersects with present functioning, and draw upon that heritage to address current challenges, this approach may repre- sent the ideal assessment method.
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