David R. Hodge, Spiritual Assessment in Social Work and Mental Health Practice. New York & Chichester: Columbia University Press, 2015, 224 pp. (Hbk). ISBN: 978-0-231-16396-5, £33.00/$45.00.

Reviewed by: Revd Professor Mark Cobb, Senior Chaplain and Clinical Director of Therapeutics & Palliative Care, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

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The role of spirituality in social work has been the subject of discourse and debate for many years, perhaps most notably in the UK through the work of Margaret Holloway and Bernard Moss. Chaplains will find familiar themes in the social work literature about spirituality in relation to clients and practitioners, and less familiar themes about its contribution to social practices and social justice, some of which helpfully extends the interpersonal therapeutic view that often dominates healthcare spirituality. There is a dedicated publication to this subject, the Journal of Religion & Spirituality in Social Work: Social Thought, and the joint statement of ethical principles of 2012. The International Association of Schools of Social Work (IASSW) and The International Federation of Social Workers (IFSW) declare that: “Social workers should uphold and defend each person’s physical, psychological, emotional and spiritual integrity and well-being”.

One of the common challenges across health and social care is how to understand and describe a person’s spirituality so that positive attributes can be supported and more problematic aspects and needs explored and addressed. This purposeful approach to assessment, with the intention of informing decisions about care and support, faces challenges related to the subtleties and nuances of how people experience and express the spiritual in their lives. For example, asking people whether they have a religion is likely to elicit a different sort of response to asking them how they make sense of their lives, and yet identity and meaning-making can both be ways that people say something about their spirituality. If we are to uphold and defend each person’s spiritual integrity and well-being, then in addition to skilled interpersonal-communication, we need sensitive, reliable and consistent ways to explore spirituality with those we serve and care for. As Hodge explains in his text devoted to methods and tools of spiritual assessment, the knowledge derived from this approach, “equips practitioners to respect client autonomy, identify spiritual assets, build therapeutic rapport, and design interventions that are congruent with the clients’ value systems”.

Hodge writes out of a School of Social Work and he provides a clearly argued rationale and ethical justification for the routine use of spiritual assessment in social work practice much of which translates easily to chaplaincy practice. The core chapters are devoted to approaches to spiritual assessment and begin with brief assessment methods that can be administered to all clients as part of an holistic needs evaluation, such as FICA and HOPE. The information derived from the preliminary assessment is then used to determine whether a comprehensive assessment is warranted which leads Hodge to present five “modally different” spiritual assessment methods: spiritual histories, spiritual life-maps, spiritual genograms, spiritual eco-maps and spiritual ecograms. Each method is subject to a short introduction, an illustrated case example, a discussion about the practice of administering the method that refers back to the case, and reflections on the strengths and limitations of the methods. In addition, Hodge introduces a method of assessment aimed at clients who express the irrelevance of spirituality or choose not to disclose spiritual matters which requires a practitioner to take a more implicit approach by remaining sensitive to the spiritual dimension and switching on their “spiritual radar”.

In the penultimate chapter Hodge begins by taking a critical overview of spiritual assessments and deals with more methodological matters such as validity and trustworthiness, and the use of quantitative measures. However, one of the strengths of this text is that Hodge never stays far away from issues of professional practice and he moves on to address two issues for social workers conducting spiritual assessments. The first he terms “spiritual countertransference” by which he means the ways in which practitioners unwittingly transfer onto a client their own unresolved spiritual issues or biases. This is a subject seldom addressed in chaplaincy discourses and Hodge’s all too brief discussion points to the primacy of safeguarding client welfare. The second issue Hodge terms “faux spiritual direction” in which social work practitioners attempt to provide spiritual direction despite it being outside of their scope of practice and competence, which prompts Hodge to comment that, “collaboration with, or referral to, clergy is typically appropriate”.

Spiritual assessment methods can provide a lingua franca across different professions and services, and whilst chaplains are likely to be familiar with some of the frameworks presented, others are more firmly rooted in and developed from social work practice. Hodge provides an insightful and reflective guide to the field and there is much in the book that is of relevance and interest to chaplaincy practice. For example, the book could provide a useful text for multidisciplinary teams who wish to develop a fully holistic approach inclusive of spirituality. Even chaplains who present their practice as “loitering with intent” may find this book provides an interesting counterpoint to their more unstructured approach and may help them to reflect on how they use their own spiritual radar.