A close colleague, Dave Ray, has posted an interesting article on his website about social work and politics. His observations about the place of policitics in social work is intelligent and germane. The same should be said of religious views.
Keeping politics and religion out of therapy can be increasingly difficult. Political viewpoints, and their resultant decisions, often affect resources and funding which directly affect social work and counseling. This often creates an ethical dilemma as we fight to provide clients with up to date information without expressing our personal views on the effects these decisions have on our day to day work and the services we provide (or used to provide). The same struggles exist with regard to religion.
With the recent faith-based initiatives our field saw many secular monies being transferred to churches for the distribution of much needed services. Though churches mean well, they are not social workers. And though I am not a social worker I am sometimes one of their biggest fans. Because of the prohibitions against social workers bringing their own politics or religious views into their work, monies granted to them are typically distributed evenly to every eligible client regardless of the clients' politics or religion. The same cannot be said of many churches. Ignoring this new discrepancy in how funding is distributed is difficult at best. Where I used to be able to refer people of any religious persuasion for help with bus passes or food, I now have to screen for their religious beliefs and their willingness to practice, or at least profess, a certain religion in order to receive some services.
Aside from the political client religion can be an issue in private practice. One tricky situation can be clients' requests about a therapist's personal religious beliefs. Working in the near South it is not unusual to have clients ask me whether I am a Christian or if I believe in angels or the afterlife, etc. This presents a hurdle in the therapy which must be artfully cleared. I fight mightily to keep my religion out of the therapy room. We are not here to discuss what I believe or how I see the world. The therapy room is for the client, not the therapist. I believe that putting my religion in the therapy room puts a great burden on the client. Why? I know when I have gone for therapy of my own I have had therapists who bring their religion into the session. And I resent it. Not only does it shut me down from what I was trying to express, I now have to deal with their religious beliefs. And if those beliefs are contrary to my own I feel I have to defend myself from incoming propaganda. I should not have been put in the position of having to defend my mind from incoming dogma. How on earth was I supposed to open up and trust a therapist who was pelting me with her own dogma? I also resented the intrusion. I thought the therapy session was supposed to be for and about me! It truly made me feel cheated. (I eventually stopped seeing her and got another therapist who respected my beliefs.)
I can only assume that my clients would feel the same way. The therapy session I am having with them is for and about them - not me. So how do I handle religion in therapy? I keep mine out of the room and focus on the client's. I have worked with Christians, Jews, Muslims, Pagans, Wiccans, Satanists, Agnostics and Atheists. I even worked with an Odinist once. I work from within the client's paradigm. Sometimes I have a fairly good idea of what that might be and just need a bit of clarification. Sometimes, for instance with the Odinist, I have to work from the ground up to educate myself. Either way, the result should be that the client's religious beliefs are respected at all times.
What if those religious beliefs are causing the client or someone else harm? First I have to examine whether the harm is real or just my religious opinions creeping through. In whose mind does the "harm" exist? Mine or the clients? Is the client expressing concern about it or is it my concern? For example, does wearing a burqa cause harm? In whose opinion? Mine or the client's? If the only harm exists in my mind I have to deal with that myself. Not put it upon the client to change their religious beliefs.
However, if the belief results in an obvious harm to others it may be another matter. I may have to work to separate delusional thinking from religious beliefs or to confront discrepancies in someone's religious framework - without compromising the core beliefs themselves. If I can't navigate this successfully, I may refer them to a minister in their faith or a pastoral counselor. I would never take it upon myself to discredit someone's religious beliefs as a whole. I think a person's religious beliefs are one of the most core belief systems we have and should not be idly tampered with.
Example:
I will never forget talking to a 17 year old boy who was brought to me after he had attempted to stab his mother the night before. When asked what was happening he confessed to me that God had told him that his mother had been practicing witchcraft on him and that she needed to be stabbed to death to get the evil out of her. At this point I did not say to him, "Oh, there is no God!" or "That is hogwash!" This boy really believed God was speaking to him and telling him to do these things. So I asked him more about the characteristics of his God. He described a loving, caring, nurturing entity who was deeply concerned about mankind. At this point I confronted him about the disparity between the God he described and the voice demanding the death of his mother. "How could the God you describe tell you to do such a thing?" "Is it possible the voice in your head claiming to be God is not really God?"
My intention was to respect his overall religious beliefs while attacking the hallucinations. To tease apart the two so that he might consider the possibility that they were separate.
Was I right or wrong? I'll never know. I had him hospitalized for homicidal ideations. Before he was released I changed jobs and did not learn the outcome of his hospitalization. Some would suggest I was wrong. That there was the possibility that perhaps his mother really was practicing witchcraft and the voice in his head really was God and his mother really should have been killed.
What can I say? I have to hope that was not true.
But this is just one example of the ethical issues a therapist must endure in our attempts to juggle what's best for everyone. We need to protect others from the harm a delusional client can cause, protect the client's right to practice the religious beliefs of his or her choosing while at the same time protecting the client from our own religious beliefs or indoctrination.
No wonder I'm tired at the end of the day!