1 in 3 women in the United States experience some form of sexual violence in their lifetime (NSVRC.org, 2018). To top it off, 8 out of 10 rapes are committed by someone the victim knows, dispelling the common myth about the stranger jumping out of the bushes to grab an unsuspecting woman (RAINN.org, 2019). I use the term sexual violence in this post to include any of the following; sexual exploitation, sexual abuse, sexual harassment, cyber harassment, voyeurism degrading sexual imagery, indecent exposure, and stalking (Catholic American Eyes in Korea, 2018). There are many consequences to a woman/girl who has experienced sexual violence; poor mental and physical health, anxiety, PTSD, eating disorders, suicide, depression, inability to form bonds, and re-victimization, to name a few (NSVRC.org, 2018; womenshealth.gov, 2019; Krejci et al., 2004; Redmond, 2014). While social workers have many tools, resources, and education on how to address these issues stemming from sexual abuse, what about spiritual injury that may also result after abuse occurs?

Before I go further, let me define spiritual injury and what the difference is between spiritual abuse and spiritual injury. Spiritual injury is a result of an event or series of events that produce an inherent and irreconcilable contradiction between what people instinctively believe to be true about themselves and what is actually true (Scott, 2019). For example, “bad things happen to bad people and good things happen to good people. Therefore, God must be punishing me for being a bad person”, is an example of spiritual injury. Spiritual abuse stems from a spiritual leader, system, or indoctrinated individual’s attempts to control or manipulate another (Kingdon, 2017). It occurs in a religious context and negatively impacts the individual’s spirituality and/or diminishes/breaks their spirit (Kingdon, 2017). As you can see, spiritual abuse and spiritual injury can go hand-in-hand. While it is not a requirement that someone experiences spiritual abuse to develop spiritual injury, it can greatly increase the chance that they will develop it.

• Spiritual injury can look like the following for women and girls who have experienced abuse: Negative views of God
• Belief they are receiving divine punishment
• Spiritual discontentment
• Feeling abandoned by God
• Belief that God is punitive, rigid, disapproving
• Decreased involvement in formal religion
• “Why is God punishing me?”
• Belief God failed to protect them

(Krejci et al., 2004; Falsetti et al., 2003; Kane et al., 1993; Murray-Swank et al., 2005; Dura-Vila et al., 2013)

Why is it important for social workers to understand and address spiritual injury?

• 77% of Americans consider religion somewhat important in their lives
• 88% identify as spiritual
• Spiritual/religious beliefs comprise how individuals understand and relate to their world as well as how to react to and cope with trauma
• Experience of trauma can create a spiritual/religious crisis
• Clients have repeatedly expressed their need for discussions of religion/spirituality and for it to be included in their treatment

(Dura-Vila et al., 2013; Zenkert et al., 2014; Oxhandler, 2016)

Solace for the Soul: A Journey Towards Wholeness is a non-denominational intervention rooted in theistic spiritual worldview that encompasses 5 major monotheistic religions of which 80% of North America and Europe belong to (Judaism, Christianity, Islam, Zoroastrianism, Sikhism) (Murray-Swank et al., 2005). It is an 8-session intervention held 1-2 times a week for 1.5-2 hour and includes: opening/closing prayer, focused breathing, spiritual imagery, poems/reflection, two-way journaling to God, spiritual rituals, discussion (Murray-Swank et al., 2015). Examined effectiveness of spiritually-integrated intervention and included seven themes: images of God, abandonment and anger at God, spiritual connection, shame, the body and sexuality (Murray-Swank et al., 2005).

After receiving this intervention clients reported results:

• Clients reported spiritual changes in use of positive religious coping, spiritual well-being, images of God
• Increased coping and ability for clients to “work towards God” by confronting struggles
• Moved from place of anger, abandonment, and spiritual disconnection to place of increased hope, connection, spiritual renewal

More research and study trials need to be conducted with this intervention, as the sample size for the study were non-generalizable due to small sample size (2). But, it shows promise for interventions focused on spiritual healing from sexual abuse for women.

Social workers make up largest proportion of mental health workers in the U.S., we need to be fully equipped to assess, intervene, and respect religion/spirituality issues as they arise from sexual abuse. Unfortunately, reasons that workers might hesitate to address these issues:

• Lack of training in assessment and intervention with clients experiencing spiritual injury
• Lack of courses offering training in spiritual assessment
• Discussions on religion/spirituality lack application to practice
• Fear of imposing personal beliefs on client (proselytizing) and blurring boundaries between personal and professional boundaries

(Oxhandler et al., 2015)

Think about it like this: you would not “hesitate to ask how the incest/sexual abuse may have affected the client’s sexuality”. Therefore, it would make sense that the worker “can ask how the sexual abuse might have affected her spirituality” (Kane et al., 1993).

What are some things that workers can do to empower clients in the area of spirituality and address spiritual injury in their female clients?

• Address importance of religion/spirituality in work with clients with social work graduate students so emerging workers in the field have a good knowledge base on spiritual injury
• Create/attend training courses related to religious/spiritual integration with clients
• Consider spiritual based interventions like Solace for the Soul for future research and implementation
• Talk with someone about their faith
• Learn more about other religions/spiritual beliefs to further your knowledge and enhance scope of practice

(Oxhandler et al., 2015)

 

 

According to the NASW code of ethics, social workers must practice within their areas of competence and develop and enhance their professional expertise. Social workers continually strive to increase their professional knowledge and skills and to apply them in practice. The code of ethics also mentions cultural diversity as a large piece of social worker’s values. Cultural diversity among other things, also encompasses religious/spiritual diversity. It’s incredibly important that we as social workers be equipped with the skills and knowledge to effectively and ethically integrate our client’s religion/spirituality into treatment and sessions.

 

 

References

Dura-Vila, G., Littlewood, R., & Leavey, G. (2013). Integration of sexual trauma in a religious narrative: transformation, resolution and growth among contemplative nuns. Transcultural Psychiatry, 50(1), pp. 21-46.

Eshuys, D., & Smallbone, S. (2006). Religious affiliations among adult sexual offenders. Sexual Abuse: A Journal of Research and Treatment, 18(3), pp. 279-288.

Falsetti, S.A., Resick, P.A., & Davis, J.L. (2003). Changes in religious beliefs following trauma. Journal of Traumatic Stress, 16(4), pp. 391-398.

GRACE (2013). Sexual offenders in the christian community: how do they operate and how do we respond? Retrieved from https://northhillschurch.com/wp-content/uploads/2013/10/Sexual-Offenders-Within-The-Christian-Community-BT.pdf.

Kane, D., Cheston, S.E., & Greer, J. (1993). Perceptions of god by survivors of childhood sexual abuse: an exploratory study in an underresearched area. Journal of Psychology and Theology, 21(3), pp. 228-237.

Krejci, M.J., Thompson, K.M., Simonich, H., Crosby, R.D., Donaldson, M.A., Wonderlich, S.A., & Mitchell, J.E. (2004). Sexual trauma, spirituality, and psychopathology. Journal of Child Sexual Abuse, 13(2), pp. 85-103.

Murray-Swank, N.A., & Pargament, K.I. (2005). God, where are you? Evaluating a spiritually-integrated intervention for sexual abuse. Mental Health, Religion & Culture, 8(3), pp. 191-203.

National Sexual Violence Resource Center (2018). Statistics. Retrieved from https://www.nsvrc.org/statistics.

Oxhandler, H.K., Parrish, D.E., Torres, L.R., & Achenbaum, A.W. (2015). The integration of clients’ religion and spirituality in social work practice: a national survey. Social Work, 60(3), pp. 228-237.

Oxhandler, H.K. (2016). Revalidating the religious/spiritually integrated practice assessment scale with five helping professions. Research on Social Work Practice, 29(2), pp. 223-233.

Redmond, L.W. (2014). Spiritual coping tools of religious victims of childhood sexual abuse. Journal of Pastoral Care & Counseling, 68(1), pp. 1-8.

Women’s Health (2019). Sexual assault. Retrieved from https://www.womenshealth.gov/relationships-and-safety/sexual-assault-and-rape/sexual-assault.

Scott, V.(2019). Spiritual injuries: a definition. Retrieved from https://victorscott.org/2016/09/19/spiritual-injuries-a-definition/.

Zenkert, R.L., Brabender, V., & Slater, C. (2014). Therapists’ responses to religious/spiritual discussions with trauma versus non-trauma clients. Contemporary Psychotherapy, 44, pp. 213-221.