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Article Review of: "Developing a Spiritual Assessment Toolbox: A discussion of the Strengths
and Limitations of Five Different Assessment Methods"
For our week five module assignment we were instructed to choose an article to read and
review. The article that I chose as my review article is an article by David R. Hodge (2005) titled
"Developing a Spiritual Assessment Toolbox: A discussion of the Strengths and Limitations of
Five Different Assessment Methods". In this review content will be thoroughly discussed during
which a summary of the article would be given, my individual interaction to the content, and an
example of how the article contents can be applied in a counseling situation.
Client assessments are an important part of counseling methods that allow the counselor
to monitor and track certain aspects of a client’s well-being. Monitoring a client’s well-being
through such assessments can provide a plethora of important information crucial to proper
treatment of a client. Hodge (2005) states that “Assessment provides a method of identifying
spiritual assets that can be operationalized in treatment and discharge planning” (p. 314). In his
(2005) article Dr. Hodge outlines five different assessment methods and elaborates on both
strengths and weaknesses of each.
Summary
Hodges (2005) article is based on five different assessment models that can be utilized in
a way that will help a counselor to understand what kind of spiritual worldview and culture that
their client may have. Dr. Hodge notes that “Hindus, evangelical Christians, Muslims, Mormons,
Pentecostal Christians, and orthodox Jews are all examples of populations who have developed
distinct culture” (2005, p. 314). He further notes that the Joint Commission of Healthcare
Organizations recommends spiritual assessment be conducted and that a client’s spirituality
should be assessed to determine their denomination.
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The five assessment methods that Hodge (2005) chose to elaborate on in his article are
(1) spiritual histories, (2) spiritual life maps, (3) spiritual genograms, (4) spiritual ecomaps, and
(5) spiritual ecograms. Hodge (2005) points out two goals of assessments and those are first to
identify the effect of client spirituality and second is to establish whether or not a more
comprehensive spiritual assessment will be needed. In his article Dr. Hodge also gives both
strengths and weaknesses of each of these types of assessments which will be summarized in the
following paragraphs.
Spiritual Histories
Hodge (2005) notes that spiritual histories assessments done orally are the most common
type of assessment. This type of assessment is done with two question sets. The purpose of these
sets of questions is to first allow the counselor to gain additional knowledge about the client that
can be utilized in a manner to help the client tell their story. This first set of questions is referred
to as the Initial Narrative Framework. The second set of questions known as the Interpretive
Anthropological Frameworks is utilized in a manor to gain perspective on a client’s spirituality.
Dr. Hodge points out that strengths to spiritual histories is that it works well with clients
who like verbal communicative methods, and that they can be easily conducted in a manner that
builds a good relationship with a client. Dr. Hodge also points out limitations of spiritual
histories is that the focus may be less on current issues that the client are dealing with and that
not all clients are comfortable with being verbal with personal issues.
Spiritual Life maps
Spiritual life maps, as stated by Hodge (2005) are less verbal and utilize drawings to for a
sort of map of a clients’ spiritual life which would also depict their relationship with God.
Typically, it is requested that a client include and spiritually significant events in the map, as
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well as various struggles they may have faced. According to Dr. Hodge, some strengths of
spiritual life maps are that they are client directed, have less risk in damaging client/counselor
relationships, and it also helps the counselor to gain a much better perspective of the client’s
worldview. Weaknesses mention by Hodge (2005) are that clients may not like to dray and
would like to be more verbal, and the fact that the counselor can feel removed from the
assessment process at times.
Spiritual Genograms
Hodge (2005) makes the point that spiritual genograms provide the counselor with a
graphic of client spirituality over as many as three generations giving both the client and
counselor an understanding of what role spirituality has played in client family history. Some
strengths that are mentioned by Dr. Hodge are that spiritual genograms do a great job of
effectively bringing spirituality into a client’s treatment plan and also family problems can often
be effectively addressed through this assessment. Two of the weaknesses that Hodge (2005)
notes are that these types of assessments can be lengthy and time consuming and not all clients
connect with or relate to past family history and struggles so a client may find that there would
be better use of their time in other assessment methods.
Spiritual Ecomaps
Spiritual ecomaps allow the client and counselor to “Focus on clients’ current spiritual
relationships” and “focuses on that portion of the clients’ spiritual story that exists in present
space” (Hodge, 2005 p. 319). Dr. Hodge also notes that with spiritual ecomaps a line is drawn
between family and spiritual systems a client may have in place. Strengths include that a spiritual
ecomap can be quickly and easily constructed while focusing on a clients’ spiritual strength and
also can serve as the main topic of discussion (Hodge, 2005). Weaknesses that Dr. Hodge
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mentions are that ecomaps focus mainly on client systems and not necessarily on the client
themselves. Spiritual ecomaps limit the client speaking to the point where a client may feel that it
is less appealing to them.
Spiritual Ecograms
The final assessment included in Dr. Hodges list of five is spiritual ecograms. Hodge
(2005) notes that spiritual ecograms are a collaboration between spiritual ecomaps and
genograms which utilizes current space and also information that spans over a period of time and
establishes connections between past and present situations. In this type of assessment
relationships and their nature are connected with systems by drawing lines (Hodge, 2005). One
important strength of a spiritual ecogram is that it is able to “illustrate current and historical
resources” (Hodge, 2005 p. 322). Weaknesses include the fact that spiritual ecograms are more
complex and more of a simple method is often times preferred by the counselor.
Finally Dr. Hodge’s strong conclusion notes that 40% of clients feel that spirituality is an
important part of their lives and keeps them going as a coping mechanism so assessment is
important. Dr. Hodge also points out that although he has discussed these five assessments that
other assessment methods exist and may be more appropriately utilized at times and that no one
assessment would be ideal in all cases.
Interaction
When I first read the title to this article I knew that it would be something that I would
find useful. I feel strongly that client assessments are important to establishing where they are
and how they feel toward certain aspects of their lives. Assessing their worldview is as important
as assessing their spirituality. Upon completing this article I found a significant amount of useful
information that I did not know about before.
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First, I would have never have thought that having an adult client draw graphs, or maps
would properly assess how they felt about relationships with God, spirituality or past family
history. I thought the best assessment would be verbal or having the client answer questions on
paper. Second I liked how the article gave strengths and weaknesses to all five assessment types
which I would not have established on my own. The author was not biased toward any one
particular assessment method. In fact, the author noted that there are other methods not
mentioned in his article that could be considered more appropriate.
One thing I felt the article lacked was how to get to the point of which assessment to use.
For example, should you ask the client which method they would prefer or should the counselor
choose the method they feel would be best for the client. The article mentioned that some clients
are more verbal than others, some are not as artistic as another, and that some are more time
consuming assessments so they are less preferred. So would a counselor determine the exact
assessment that can be used most effectively without wasting client time? I know the article was
not designed to be a step by step manual on these five assessment methods but I feel that more
information could have been provided.
I wished there were some sort of statistics included as to rank of methods used. Also
some demographic statistics would also be useful. For example which assessment is most useful
among certain age groups? Would those with a post-modern worldview prefer a different
assessment method than those with a modern worldview? I am sure that this is information that
would have to be compiled over time but it would be useful to know for further study on
assessment methods.
Application
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For the application section of this review I chose a client who is female that I will refer to
as Aaliyah. Aaliyah recently converted to Christianity from the Muslim faith. Her family is
currently and has always been predominantly Muslim and she is struggling because her family
does not condone her newly found relationship with God. She is struggling in her faith because
of doctrine that she was taught her whole life which conflicts with her newfound faith. She has
requested counseling because at times she feels overwhelmed trying to make sense of it all, feels
as though she has let her family down, and sometimes questions whether or not she would be
better off without the stresses of religion.
In this type of situation I feel a spiritual assessment is not only warranted by extremely
important. In her first session it was noted that Aaliyah seems very timid and is a quiet individual
who struggles to say what is on her mind and what is bothering her. In most cases she will not
speak unless she is asked to do so. For her specific case I would start by utilizing a spiritual life
map assessment. I would want to assess what areas are most important to the client at this point
in her life but also to understand her worldview and spiritual family history.
Aaliyah is not a verbal person in general so one of the weaknesses that Dr. Hodge
mentioned would not apply to her. Aaliyah would more than likely feel more comfortable
spending more time in a quiet environment where she could take what time she needs to express
how she feels. Another weakness that Dr. Hodge mentioned was that counselors at times can feel
removed from the process, however in this case it may be best for the counselor to observe and
take additional time allowing the session and assessment to be more client directed. I do not feel
in this case that it would be making poor use of therapeutic time. Finally this assessment would
allow me as the counselor to build rapport and a strong client/counselor relationship with a client
whose family faith may consider it a bad thing to seek council from those outside of their faith.
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I did not find anything in the ACA code of ethics that would prohibit such an assessment
with a client. If the client came for spiritual based counseling and signed and informed consent
the client would be well within their legal and ethical boundaries to perform any of the five
assessment that Dr. Hodge wrote about. As long as the counselor recognizes when a different
method may be more appropriate and adheres to such a method, they will be keeping the clients
well-being as their main priority.
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References
Hodge, D. R. (2005). Developing a Spiritual Assessment Toolbox: A Discussion of the Strengths
and Limitations of Five Different Assessment Methods. Health & Social Work, 30(4),
314–323. doi: 10.1093/hsw/30.4.314
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